Post-thrombolytic blood pressure and symptomatic intracerebral hemorrhage

Show simple item record

dc.contributor Helsingin yliopisto, Lääketieteellinen tiedekunta fi
dc.contributor University of Helsinki, Faculty of Medicine en
dc.contributor Helsingfors universitet, Medicinska fakulteten sv
dc.contributor.author Waltimo, Tuure
dc.date.issued 2016
dc.identifier.uri URN:NBN:fi:hulib-201611243093
dc.identifier.uri http://hdl.handle.net/10138/169763
dc.description.abstract Background and purpose: Most guidelines for intravenous thrombolysis (IVT) in acute ischaemic stroke patients advise keeping systolic blood pressure (BP) below 180/105 mmHg prior to the bolus injection. Less is known about optimal management of BP thereafter. We assessed temporal changes in post-thrombolytic systolic BP values and their impact on development of symptomatic intracerebral hemorrhage (sICH). Methods: The study cohort included 1868 consecutive acute ischaemic stroke patients treated with IVT at the Helsinki University Central Hospital. sICH was defi ned according to the European Cooperative Acute Stroke Study II (ECASS-II) (primary outcome), National Institute of Neurological Disorders and Stroke, and Safe Implementation of Thrombolysis in Stroke criteria. We evaluated BP at admission, prior to IVT and at 2, 4, 8, 12, 24 and 48 h after thrombolysis. We used univariate and multivariable models to test the effect of BP at various time-points on development of post-thrombolytic sICH. Results: Prevalence of sICH in the cohort was 5.8% (ECASS-II). Patients with sICH had significantly higher systolic BP at several time-points after IVT compared with those without sICH (P < 0.01 at 2 and 4 h; P < 0.05 at 12 and 48 h). The odds ratios for development of sICH per 10 mmHg increase in BP were 1.14 [95% confi dence interval (CI), 1.03–1.25], 1.14 (95% CI, 1.03–1.25), 1.12 (95% CI, 1.01–1.23) and 1.12 (95% CI, 1.01–1.23), respectively. At 8 h, we observed a trend (P = 0.07) for ECASS-II and a significant effect (P < 0.05) for National Institute of Neurological Disorders and Stroke, and Safe Implementation of Thrombolysis in Stroke criteria. Thus, the only timepoint with no difference observed was 24 h. Conclusions: Patients with post-thrombolytic sICH have signifi cantly higher systolic BP at several time-points compared with patients without sICH. en
dc.language.iso eng
dc.publisher Helsingfors universitet sv
dc.publisher University of Helsinki en
dc.publisher Helsingin yliopisto fi
dc.subject Stroke en
dc.subject Thrombolysis en
dc.subject Blood pressure en
dc.title Post-thrombolytic blood pressure and symptomatic intracerebral hemorrhage en
dc.type.ontasot pro gradu-avhandlingar sv
dc.type.ontasot pro gradu -tutkielmat fi
dc.type.ontasot master's thesis en
dc.subject.discipline Neurology en
dc.subject.discipline Neurologia fi
dc.subject.discipline Neurologi sv
dct.identifier.urn URN:NBN:fi:hulib-201611243093

Files in this item

Files Size Format View
Waltimo_et_al-2 ... n_Journal_of_Neurology.pdf 185.5Kb application/pdf View/Open

This item appears in the following Collection(s)

Show simple item record