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·2025
Blood pressure management based on infarct volume after successful endovascular thrombectomy
Jae Wook Jung, Kwang Hyun Kim, Jaeseob Yun, Haram Joo, Young Dae Kim, JoonNyung Heo, Hyungwoo Lee, Byung Moon Kim, Dong Joon Kim, Na Young Shin, Bang‐Hoon Cho, Seong Hwan Ahn, Hyungjong Park, Sung‐Il Sohn, Jeong-Ho Hong, Tae-Jin Song, Yoonkyung Chang, Gyu Sik Kim, Kwon–Duk Seo, Kijeong Lee, Jun Young Chang, Jung Hwa Seo, Sukyoon Lee, Jang-Hyun Baek, Han‐Jin Cho, Dong Hoon Shin, Jinkwon Kim, Joonsang Yoo, Minyoul Baik, Yo Han Jung, Yang‐Ha Hwang, Chi Kyung Kim, Jae Guk Kim, Il Hyung Lee, Jin Kyo Choi, Chan Joo Lee, Sungha Park, Soyoung Jeon, Hye Sun Lee, Sun U. Kwon, Oh Young Bang, Ji Hoe Heo, Hyo Suk Nam, and for the OPTIMAL-BP trial investigators
IF 4.5 (2025) European Stroke Journal
초록

Abstract Introduction: While the efficacy of endovascular thrombectomy (EVT) in large core infarcts has been established, the influence of blood pressure (BP) management on functional outcomes based on infarct volume remains unclear. Patients and methods: We conducted a secondary analysis of the Outcome in Patients Treated With Intra-Arterial Thrombectomy–Optimal Blood Pressure Control (OPTIMAL-BP) trial, which compared intensive (systolic BP < 140 mmHg) versus conventional (systolic BP 140–180 mmHg) BP management within the first 24 h following successful recanalization. Patients were grouped based on an infarct volume cut-off of 50 ml, assessed 24 h post-EVT. The primary efficacy outcome was functional independence (modified Rankin Scale of 0–2) at 3 months. Change of predicted probability for functional independence between BP managements, as infarct volume varied, was assessed. Results: Of the 300 patients, 222 (74.0%) were in the infarct volume ⩽50 ml group and 78 (26.0%) were in the infarct volume >50 ml group. The conventional management was significantly associated with a higher rate of functional independence in the infarct volume ⩽50 ml group (adjusted odds ratio [AOR], 2.06 [95% CI, 1.12–3.86]). In the infarct volume >50 ml group, the proportion of patients with functional independence was not significantly different between BP managements (AOR, 1.52 [95% CI, 0.46–5.04]). The interaction effect between the infarct volume groups and BP managements was not significant. As infarct volume increased, the difference in predicted probability of functional independence between BP managements decreased. Discussion and conclusions: Conventional BP management showed greater benefits for achieving functional independence at 3 months when infarct volumes were smaller. As infarct volume increased, the impact of BP management strategies on functional outcomes decreased. Registration: ClinicalTrials.gov (NCT04205305)

키워드
MedicineModified Rankin ScaleOdds ratioCardiologyInternal medicineBlood pressureHemodynamicsVolume (thermodynamics)AnesthesiaIschemic stroke
타입
Article
IF / 인용수
4.5 / 0
게재 연도
2025