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Journal of Stroke ; : 54-63, 2024.
Artículo en Inglés | WPRIM | ID: wpr-1044080

RESUMEN

Background@#and Purpose The optimal blood pressure (BP) control after successful endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) with large vessel occlusion (LVO) remains debatable. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that evaluate the efficacy and safety of standard BP control (with systolic BP ≤180 mm Hg) versus intensive BP control (systolic BP <140 mm Hg) during the 24 hours after successful EVT in AIS with LVO. @*Methods@#PubMed, Scopus, the Cochrane Central Register of Controlled Trials, and Embase were searched to identify relevant trials. The crude odds ratio (OR) and 95% confidence interval (CI) were calculated and estimates using random-effects models were pooled. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO ID: CRD42023450673). @*Results@#Four RCTs involving 1,559 participants were included. Regarding efficacy outcomes, intensive BP control was associated with a lower likelihood of functional independence (OR: 0.68; 95% CI: 0.51–0.91 for modified Rankin Scale [mRS] ≤2) and walking without assistance (OR: 0.65; 95% CI: 0.53–0.81 for mRS ≤3). For safety outcomes, consistent with the efficacy findings, intensive BP control was significantly associated with severe disability or death (mRS 5 or 6) (OR: 1.34; 95% CI: 1.07–1.69). However, there were no significant differences including all-cause mortality, any intracerebral hemorrhage (ICH), symptomatic ICH, parenchymal hematoma type 2, and stroke recurrence. @*Conclusion@#While all four RCTs were conducted to demonstrate the superiority of intensive BP control over standard BP control, standard BP control may be beneficial for the outcome after EVT for AIS with LVO without increasing adverse safety outcomes. Caution should be needed with the application of intensive BP control during the 24 hours following successful recanalization after EVT.

2.
Artículo en Inglés | WPRIM | ID: wpr-1041606

RESUMEN

objectives@#:Far-infrared (FIR) lights have been investigated for sleep quality intervention. We sought to measure the advantageous effects of FIR in sleep using polysomnographic data as the objective outcomes. @*Methods@#:The ten healthy volunteers were enrolled in a single-center, prospective, patient-blind, single-arm trial. Individuals slept on a sham mattress and a FIR emitting mattress with polysomnography for one night each. @*Results@#:Sleep efficiency showed an increasing trend but was not statistically significant. PSQI-K significantly decreased (p=0.013). The latency to REM of the baseline was shorter than that of the intervention (p=0.008). Though there was no statistical significance, Stage N1 and N2 were shortened, and Stage N3 was prolonged after the intervention compared to the baseline. @*Conclusions@#:The FIR-emitting mattresses improved sleep quality on self-reported insomnia. We suggested the candidate for the markers altered by the FIR therapy, such as the normalization of REM latency and increased N3 sleep.

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