Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic Patients

Introduction Higher blood pressure (BP) is considered to be harmful in patients who undergo mechanical thrombectomy (MT), however, the impact of BP post‐MT based on comorbidities like anemia has not been well studied. We aim to determine the association of 24‐h post‐MT BP parameters with mortality d...

Full description

Bibliographic Details
Main Authors: Taha Nisar, Toluwalase Tofade, Shaul Shaulov, Sara Shapouran, Osama Abu‐hadid, Priyank Khandelwal
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Stroke: Vascular and Interventional Neurology
Online Access:https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.150
_version_ 1797803516461318144
author Taha Nisar
Taha Nisar
Toluwalase Tofade
Shaul Shaulov
Sara Shapouran
Osama Abu‐hadid
Priyank Khandelwal
author_facet Taha Nisar
Taha Nisar
Toluwalase Tofade
Shaul Shaulov
Sara Shapouran
Osama Abu‐hadid
Priyank Khandelwal
author_sort Taha Nisar
collection DOAJ
description Introduction Higher blood pressure (BP) is considered to be harmful in patients who undergo mechanical thrombectomy (MT), however, the impact of BP post‐MT based on comorbidities like anemia has not been well studied. We aim to determine the association of 24‐h post‐MT BP parameters with mortality depending on the anemia status. Methods We conducted a retrospective chart review of patients who underwent MT at a comprehensive stroke center from 7/2014 to 12/2020. Patients were dichotomized into anemic and non‐anemic groups based on the World Health Organization’s definition of anemia [hemoglobin < 12.0 g/dL in women and < 13.0 g/dL in men]. We performed a binary logistic regression analysis controlling for baseline parameters, with the 24‐h post‐MT BP parameters as predictors. The primary outcome was 3‐month mortality. Results 220 patients met the inclusion criteria. The 3‐month mortality rate was 27.27%. In the multivariable analysis, the 24‐h parameters of a lower mean DBP (65.53±9.73 vs. 71.94±10.16; OR, 0.92; 95% CI, 0.86‐0.98; P 0.007), lower mean MAP (85.7±8.65 vs. 91.38±10; OR, 0.93; 95% CI, 0.86‐0.99; P 0.02), a lower minimum DBP (49.27±10.51 vs. 55.1±11.23; OR, 0.93; 95% CI, 0.88‐0.99; P 0.019), a lower minimum MAP (68.96±9.54 vs. 74.73±10.47; OR, 0.93; 95% CI, 0.87‐0.99; P 0.023) were significantly associated with mortality in patients with anemia. There was no association between 24‐hour BP Parameters post‐MT and mortality in non‐anemic patients. Conclusions In our study, lower BP parameters were associated with higher 3‐month mortality in anemic patients, however, this effect was not found in non‐anemic patients. Anemia induces a relative hypoxic state in target tissue in the event of an increase in metabolic demand such as stroke. Higher BP post‐MT can potentially promote perfusion and thus is not associated with worse outcomes in anemic patients post‐MT, whereas in non‐anemic patients it may potentially lead to reperfusion injury.
first_indexed 2024-03-13T05:23:08Z
format Article
id doaj.art-3a9bdeb4e0ea43d29d5e6462b57272ed
institution Directory Open Access Journal
issn 2694-5746
language English
last_indexed 2024-03-13T05:23:08Z
publishDate 2023-03-01
publisher Wiley
record_format Article
series Stroke: Vascular and Interventional Neurology
spelling doaj.art-3a9bdeb4e0ea43d29d5e6462b57272ed2023-06-15T10:40:48ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-03-013S110.1161/SVIN.03.suppl_1.150Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic PatientsTaha Nisar0Taha Nisar1Toluwalase Tofade2Shaul Shaulov3Sara Shapouran4Osama Abu‐hadid5Priyank Khandelwal6University of South Alabama Mobile Alabama United States of AmericaUniversity of South Alabama Mobile Alabama United States of AmericaHarvard University Boston Massachusetts United States of AmericaRutgers New Jersey Medical School Newark New Jersey United States of AmericaMontefiore Medical Center New York City New York United States of AmericaMount Sinai Beth Israel Hospital New York City New York United States of AmericaRutgers New Jersey Medical School Newark New Jersey United States of AmericaIntroduction Higher blood pressure (BP) is considered to be harmful in patients who undergo mechanical thrombectomy (MT), however, the impact of BP post‐MT based on comorbidities like anemia has not been well studied. We aim to determine the association of 24‐h post‐MT BP parameters with mortality depending on the anemia status. Methods We conducted a retrospective chart review of patients who underwent MT at a comprehensive stroke center from 7/2014 to 12/2020. Patients were dichotomized into anemic and non‐anemic groups based on the World Health Organization’s definition of anemia [hemoglobin < 12.0 g/dL in women and < 13.0 g/dL in men]. We performed a binary logistic regression analysis controlling for baseline parameters, with the 24‐h post‐MT BP parameters as predictors. The primary outcome was 3‐month mortality. Results 220 patients met the inclusion criteria. The 3‐month mortality rate was 27.27%. In the multivariable analysis, the 24‐h parameters of a lower mean DBP (65.53±9.73 vs. 71.94±10.16; OR, 0.92; 95% CI, 0.86‐0.98; P 0.007), lower mean MAP (85.7±8.65 vs. 91.38±10; OR, 0.93; 95% CI, 0.86‐0.99; P 0.02), a lower minimum DBP (49.27±10.51 vs. 55.1±11.23; OR, 0.93; 95% CI, 0.88‐0.99; P 0.019), a lower minimum MAP (68.96±9.54 vs. 74.73±10.47; OR, 0.93; 95% CI, 0.87‐0.99; P 0.023) were significantly associated with mortality in patients with anemia. There was no association between 24‐hour BP Parameters post‐MT and mortality in non‐anemic patients. Conclusions In our study, lower BP parameters were associated with higher 3‐month mortality in anemic patients, however, this effect was not found in non‐anemic patients. Anemia induces a relative hypoxic state in target tissue in the event of an increase in metabolic demand such as stroke. Higher BP post‐MT can potentially promote perfusion and thus is not associated with worse outcomes in anemic patients post‐MT, whereas in non‐anemic patients it may potentially lead to reperfusion injury.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.150
spellingShingle Taha Nisar
Taha Nisar
Toluwalase Tofade
Shaul Shaulov
Sara Shapouran
Osama Abu‐hadid
Priyank Khandelwal
Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic Patients
Stroke: Vascular and Interventional Neurology
title Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic Patients
title_full Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic Patients
title_fullStr Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic Patients
title_full_unstemmed Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic Patients
title_short Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic Patients
title_sort abstract number 150 association of 24 hour blood pressure parameters post thrombectomy with mortality in anemic and non anemic patients
url https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.150
work_keys_str_mv AT tahanisar abstractnumber150associationof24hourbloodpressureparameterspostthrombectomywithmortalityinanemicandnonanemicpatients
AT tahanisar abstractnumber150associationof24hourbloodpressureparameterspostthrombectomywithmortalityinanemicandnonanemicpatients
AT toluwalasetofade abstractnumber150associationof24hourbloodpressureparameterspostthrombectomywithmortalityinanemicandnonanemicpatients
AT shaulshaulov abstractnumber150associationof24hourbloodpressureparameterspostthrombectomywithmortalityinanemicandnonanemicpatients
AT sarashapouran abstractnumber150associationof24hourbloodpressureparameterspostthrombectomywithmortalityinanemicandnonanemicpatients
AT osamaabuhadid abstractnumber150associationof24hourbloodpressureparameterspostthrombectomywithmortalityinanemicandnonanemicpatients
AT priyankkhandelwal abstractnumber150associationof24hourbloodpressureparameterspostthrombectomywithmortalityinanemicandnonanemicpatients