The association between baseline blood pressure, collaterals and outcome in acute ischemic stroke / 中华神经科杂志

ABSTRACT

Objective To explore the association between post-stroke blood pressure and collaterals and functional outcome in acute ischemic stroke (AIS) patients with large vessel occlusion/stenosis.Methods Consecutive AIS patients with large vessel occlusion/stenosis who had symptom onset within 6 hours in Huashan Hospital from July 2011 to October 2017 were retrospectively recruited and enrolled.Collaterals were analyzed through CT perfusion imaging.And all the patients were followed up for 3 months.And the association between baseline blood pressure,collaterals and outcomes was analyzed using multivariate linear and Logistic models.A total of 126 patients were enrolled for multivariate Logistic and linear regression analysis.Results Multivariate Logistic regression analysis revealed that with every increment of 10 mmHg (1 mmHg =0.133 kPa) systolic blood pressure,the odds of poor functional outcome increased by 20％ (unadjusted OR =1.20,95％ CI 1.02-1.42,P =0.03).After adjusting for age and sex,the odds increased by 21％ (OR =1.21,95％ CI 1.01-1.46,P =0.04).However,no statistical significance was shown after multivariate adjustment (OR--1.02,95％ CI 0.99-1.05,P =0.06).Multivariate linear regression analysis demonstrated that diastolic blood pressure (DBP) was negatively associated with the volume of hypoperfused and severely hypoperfused lesion.With every increment of 10 mmHg DBP,the volume of delay time (DT) ＞ 6 s lesion downsized by 7.6 ml (unstandardized coefficient -7.56,95％ CI-14.89--0.24,P =0.04).The DT ＞6 s/DT ＞3 s ratio was also decreased with the elevation of DBP (unstandardized coefficient-0.03,95 ％ CI-0.06--0.01,P =0.01).Conclusions For AIS patients,though higher DBP seems to be associated with better collaterals,it may still relate with poor functional outcome.