Article Figures & Data
- Figure 1
Study population. ACA, anterior cerebral artery; ASPECT, Alberta Stroke Programme Early CT; BP, blood pressure; CSCs, comprehensive stroke centres; EVT, endovascular treatment; LVOS, large vessel occlusion stroke; mRS, modified Rankin score; OTP, symptoms onset to groin puncture time.
- Figure 2
Shape of the relationship between systolic blood pressure (SBP) reduction following successful reperfusion and outcomes. (A) 90-day outcome. (B) Symptomatic intracerebral haemorrhage.
- Figure 3
Distribution of modified Rankin Scale (mRS) scores at 90 days (A) and the incidence of symptomatic intracerebral haemorrhage (sICH) (B) according to the categories of systolic blood pressure (SBP) reduction (SBPr).
- Figure 4
Relationship of levels of systolic blood pressure (SBP) following successful reperfusion according to different subgroups. (A) Relationship between SBP reduction (SBPr) and poor outcome; fully adjusted indicates ORs adjusted for age, sex, history of hypertension, diabetes mellitus, antihypertensive treatment, TOAST, baseline NIHSS and ASPECT, occlusion site and collateral circulation analysed using a multivariable logistic regression model. (B) Symptomatic intracerebral haemorrhage; adjusted for baseline NIHSS, ASPECT and collateral circulation. ASPECT, Alberta Stroke Programme Early CT; NIHSS, National Institutes of Health Stroke Scale; TOAST, Trial of ORG 10172 in Acute Stroke Treatment.
- Table 1
Baseline characteristics and demographics in patients who had successful reperfusion
mRS 0–2
n=494mRS 3–6
n=414P value sICH*
n=56Non-sICH
n=847P value Age, median (IQR), year 67 (57–74) 72 (64–78) <0.001 69 (60–77) 69 (60–76) 0.983 Male, n (%) 316 (64) 227 (54.8) 0.005 36 (64.3) 503 (59.4) 0.469 Hypertension 303 (61.3) 288 (69.6) 0.010 34 (60.7) 554 (65.4) 0.475 Diabetes mellitus 66 (13.4) 93 (22.5) <0.001 12 (21.4) 147 (17.4) 0.438 Clinical characteristics, median (IQR) Baseline NIHSS scores 13 (11–17) 16 (13–20) <0.001 16 (13–19) 14 (12–18) 0.010 Baseline ASPECT scores 9 (8–10) 8 (6–9) <0.001 8 (7–9) 9 (8–10) 0.008 IVT, n (%) 91 (18.4) 67 (16.2) 0.376 14 (25) 144 (17) 0.127 Blood pressure parameters, median (IQR) Baseline SBP, mm Hg 150 (131–164) 154 (139–170) <0.001 149 (130–160) 150 (135–168) 0.140 Baseline DBP, mm Hg 83 (74–92) 84 (75–95) 0.392 84 (74–92) 83 (74–93) 0.562 Mean SBP (24 hours), mm Hg 121 (115–128) 123 (117–130) 0.001 126 (116–133) 122 (116–129) 0.073 Mean DBP (24 hours), mm Hg 70 (65–75) 69 (63–75) 0.181 69 (65–78) 70 (64–75) 0.440 SBPr, % 17.5 (8.6–25.7) 19.2 (10.9–28.1) 0.029 14.5 (2.7–20.8) 18.3 (9.9–26.7) 0.013 DBPr, % 16 (6.2–24.2) 17.8 (7.8–27.1) 0.059 13.2 (3.9–25.1) 17.1 (7.1–26) 0.132 Continuous intravenous antihypertensive agents, n (%) 246 (49.8) 260 (62.8) <0.001 37 (66.1) 466 (55) 0.107 TOAST classification, n (%) <0.001 0.473 LAA 164 (33.2) 106 (25.6) 13 (23.2) 257 (30.3) Cardioembolic 256 (51.8) 278 (67.1) 37 (66.1) 492 (58.1) Others 74 (15) 30 (7.2) 6 (10.7) 98 (11.6) Occlusion site, n (%) <0.001 0.786 ICA 162 (32.8) 189 (45.7) 24 (42.9) 324 (38.3) MCA M1 281 (56.9) 193 (46.6) 27 (48.2) 445 (52.5) MeVO 51 (10.3) 32 (7.7) 5 (8.9) 78 (9.2) OTP, mean (IQR), min 300 (225–370) 300 (220–390) 0.486 300 (221–360) 300 (225–390) 0.849 OTR, mean (IQR), min 349 (278–438) 352 (288–470) 0.087 360 (288–440) 350 (282–455) 0.695 Collateral score†, n (%) <0.001 0.008 Poor 158 (32.1) 255 (61.7) 35 (62.5) 373 (44.2) Good 334 (67.9) 158 (38.3) 21 (37.5) 471 (55.8) *5 patients missing.
†3 patients missing.
ASPECT, Alberta Stroke Programme Early CT; DBP, diastolic blood pressure; DBPr, DBP reduction; ICA, internal carotid artery; IVT, intravenous thrombolysis; LAA, large-artery atherosclerosis; MCA, middle cerebral artery; MeVO, medium vessel occlusions; NIHSS, National Institutes of Health Stroke Scale; OTP, symptoms onset to groin puncture time; OTR, symptoms onset to reperfusion; SBP, systolic blood pressure; SBPr, SBP reduction; sICH, symptomatic intracranial haemorrhage; TOAST, the Trial of ORG 10172 in Acute Stroke Treatment.
- Table 2
Relationship of SBP reduction following successful reperfusion with outcomes
SBPr Incidence, n (%) OR 95% CI P value Poor outcome* (n=414) ±10% (n=206) 80 (38.8) Reference <–10% (n=32) 15 (46.9) 1.249 0.511 to 3.048 0.626 10%–20% (n=272) 125 (46) 1.492 0.973 to 2.288 0.066 20%–30% (n=263) 114 (43.3) 1.158 0.749 to 1.790 0.509 >30% (n=135) 80 (59.3) 2.150 1.268 to 3.645 0.004 sICH† (n=56) ±10% (n=206) 17 (8.3) Reference <–10% (n=32) 4 (12.5) 1.531 0.473 to 4.955 0.477 10%–20% (n=271) 20 (7.4) 0.917 0.465 to 1.809 0.803 20%–30% (n=260) 10 (3.8) 0.476 0.212 to 1.069 0.072 >30% (n=134) 5 (3.7) 0.419 0.150 to 1.172 0.098 *Adjusted for age, sex, baseline NIHSS and ASPECT, history of hypertension and diabetes mellitus, antihypertensive treatment, TOAST classification, collateral circulation and occlusion site.
†Adjusted for baseline NIHSS, ASPECT and collateral circulation.
ASPECT, Alberta Stroke Programme Early CT; NIHSS, National Institutes of Health Stroke Scale; SBP, systolic blood pressure; SBPr, SBP reduction; sICH, symptomatic intracranial haemorrhage; TOAST, Trial of ORG 10172 in Acute Stroke Treatment.
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