Dataset Information

Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis.

ABSTRACT: We examined the relationship between an early spontaneous type V blood pressure fluctuation and the post-thrombolysis prognosis of patients with acute cerebral infarction. Patients were admitted consecutively. All patients were categorized into the type V blood pressure fluctuation group or non-type V blood pressure group. Their blood pressure was monitored before thrombolysis and until 6 h after thrombolysis. Baseline data and clinical outcomes were compared. Of 170 patients, 43 (25.2%) had an early type V blood pressure fluctuation. The National Institute of Health Stroke Scale (NIHSS) score before thrombolysis and 24 h after thrombolysis, and the modified Rankin scale score at 90 days differed significantly between the two groups (P < 0.05). Multiple logistic regression analysis showed that an unfavorable prognosis at 3 months was associated with the NIHSS score before thrombolysis (P = 0.000) but probably not with this blood pressure fluctuation (P = 0.058). An early spontaneous type V blood pressure fluctuation is common in patients with acute cerebral infarction who received venous thrombolysis, especially if they have a higher NIHSS score before thrombolysis. The type V blood pressure fluctuation may not influence patients' prognosis; however, this needs to be confirmed in future trials.

SUBMITTER: Zuo L

PROVIDER: S-EPMC4899732 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis.

Zuo Lian L Wan Ting T Xu Xiahong X Liu Feifeng F Li Changsong C Li Ying Y Zhang Yue Y Zhang Jing J Bao Huan H Li Gang G

Scientific reports 20160609

We examined the relationship between an early spontaneous type V blood pressure fluctuation and the post-thrombolysis prognosis of patients with acute cerebral infarction. Patients were admitted consecutively. All patients were categorized into the type V blood pressure fluctuation group or non-type V blood pressure group. Their blood pressure was monitored before thrombolysis and until 6 h after thrombolysis. Baseline data and clinical outcomes were compared. Of 170 patients, 43 (25.2%) had an ...[more]

PMID: 27278121

Similar Datasets

Project description:Background: Intravenous thrombolysis (IVT) therapy is currently one of the best medical treatments available for patients with acute ischemic stroke. Studies have shown that blood pressure (BP) changes in patients treated with IVT are significantly correlated with prognosis. Objective: Our study aimed to determine the relationship between BP changes during recombinant tissue plasminogen activator (rt-PA) infusion and the 3-month prognosis evaluated using the modified Rankin Scale (mRS) and determine the factors influencing BP changes during rt-PA infusion. Methods: Consecutive patients who were treated with IVT and admitted to our stroke center between May 2015 and October 2017 were analyzed retrospectively. Patients were divided into two groups according to their 3-month prognosis status: patients with mRS ≤ 2 were defined as "favorable outcome group" and those with mRS ≥ 3 as "unfavorable outcome group". First, the factors affecting prognosis after thrombolysis were analyzed. Second, we analyzed the relationship between BP and the prognosis. BP was taken before and at regular intervals of 15 min during the rt-PA infusion (1 h). The average value of BP during thrombolysis was calculated and compared to the baseline BP. BP decrease was defined as the difference between the baseline BP and the average BP, provided it was greater than 0 mmHg. Third, univariate and multivariate analyses were performed to identify factors that may contribute to BP decrease. Results: In total, 458 patients were included. Patients with a lower baseline National Institute of Health Stroke Scale (NIHSS) score (8.25 ± 5.57 vs. 13.51 ± 7.42, P < 0.001), a higher Alberta Stroke Program Early CT Score (ASPECTS; 8.65 ± 1.82 vs. 8.13 ± 2.00, P = 0.005), decreased BP during thrombolysis (69.4% vs. 59.8%, P = 0.037), and steady BP (SD < 10 mmHg) were more likely to have a favorable outcome (73.9% vs. 60.6%, P = 0.019). High baseline BP (OR > 1), hypertension history (OR < 1), and baseline ASPECTS (OR > 1) were independent factors of BP change during thrombolysis. Conclusion: Patients with decreased or steady BP during thrombolysis were more likely to have a favorable outcome. Baseline ASPECTS, baseline NIHSS score, and hypertension history influenced BP changes during thrombolysis.

Project description:BackgroundCholesterol-lowering medications, blood pressure medication, insulin, and exogenous hormones (including hormone replacement therapy, oral contraceptives, and minipills) are commonly utilized in clinical practice. Recent studies indicate that the use of these medications may significantly influence the occurrence and progression of cerebral infarction. This study aims to investigate the relationship between these medications and cerebral infarction using Mendelian randomization (MR) analysis, with the goal of offering valuable insights for the clinical management of cerebral infarction.MethodsTo explore the correlation between cholesterol-lowering medication, blood pressure medication, insulin, exogenous hormones, and cerebral infarction, relevant single nucleotide polymorphisms (SNPs) were extracted from the genome-wide association study (GWAS) database. Methods for univariate MR analysis include inverse variance weighting (IVW), the weighted median method, and the MR-Egger method, with IVW being the predominant approach. Subsequently, multivariable Mendelian randomization (MVMR) was conducted on the positive results obtained from the IVW analysis to verify the independent effect of each positive exposure, with IVW still predominating. The causal relationship between this class of drugs and cerebral infarction was evaluated using odds ratio (OR) and 95% confidence interval (CI). MR-PRESSO was used to test for pleiotropy. The robustness of the findings was assessed through leave-one-out analysis, Cochran's Q test, and funnel plot.ResultsUnivariate MR results indicated that the use of blood pressure medication, insulin, and cholesterol-lowering medication was significantly associated with the occurrence of cerebral infarction (all p < 0.05). However, due to the stringent inclusion criteria for SNPs, the number of available SNPs is insufficient to elucidate the association between exogenous hormone drugs, contraceptives, and cerebral infarction. Furthermore, the MVMR analysis, which builds upon univariate MR, only identified significant causal associations between blood pressure medication, insulin, and cerebral infarction (p < 0.05). The association between cholesterol-lowering medication and cerebral infarction was confounded by other positive exposures and did not demonstrate a significant causal relationship when only its independent effects were considered. After integrating the findings from both univariate and MVMR and controlling for confounding variables to the greatest extent possible, the available evidence supports only a potential causal relationship between blood pressure medication, insulin, and cerebral infarction.ConclusionThis study suggests that the misuse of blood pressure medications and insulin is a risk factor for the occurrence and progression of cerebral infarction.

Project description:ObjectiveThere is rising interest in digital health in preventive cardiology, particularly for blood pressure (BP) management. In a digital health study of early BP assessment following acute myocardial infarction (AMI), we sought to examine feasibility and the (1) proportion of post-AMI patients with controlled BP and hypotension, and (2) association between prior cardiovascular disease (CVD) and BP post-AMI.MethodsIn this substudy of the parent Myocardial infarction, COmbined-device, Recovery Enhancement (MiCORE) study, type 1 AMI patients were enrolled between October 2017 and April 2019. Participants self-monitored their BP through 30 days after hospital discharge using an FDA-approved wireless BP monitor connected with a smartphone application. Linear mixed-effects models assessed the association between prior CVD and BP trajectory post-discharge, adjusting for antihypertensive medications and a propensity score inclusive of CVD risk factors.ResultsSixty-eight AMI patients (mean age 58 ± 10 years, 75% male, 68% white race, 68% history of hypertension, 24% prior CVD) provided 2638 measurements over 30 days. The percentage of BP control <130/80 mmHg was 59.6% (95% CI: 54.3-64.9%) and <140/90 mmHg was 83.7% (95% CI: 80.3-87.2%). The percentage of systolic BP <90 mmHg was 1.1% (95% CI: 0.17-2.0%) and the percentage of diastolic BP <60 mmHg was 3.9% (95% CI: 2.6-5.2%). Prior CVD was associated with 12.2 mmHg higher mean daily systolic BP during admission (95% CI: 3.5-20.9 mmHg), which persisted over follow-up. There was no association between prior CVD and diastolic BP.ConclusionThe digital health program was feasible and ~40% of post-AMI patients who engaged in it had uncontrolled BP according to recent guideline cutpoints, while hypotension occurred rarely. The gap in BP control was especially large in patients in whom AMI represented recurrent CVD. These data suggest an opportunity for more aggressive secondary prevention early after MI as care models integrate digital health.

Dataset Information

Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis.

Publications

Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets