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Low Pulse Pressure After Acute Ischemic Stroke is Associated With Unfavorable Outcomes: The Taiwan Stroke Registry.


ABSTRACT:

Background

Pulse pressure (PP) is related to cardiac function, arterial stiffness, fluid status, and vascular events. This study aimed to explore the prognostic role of PP upon admission in patients with acute ischemic stroke (AIS) based on a nation-wide stroke registry.

Methods and results

We evaluated the association between PP upon admission and outcomes 3 months after a stroke in patients who had an AIS registered in the Taiwan Stroke Registry, including 56 academic and community hospitals between 2006 and 2013. Three months after the stroke, unfavorable outcomes were defined using a modified Rankin scale of 3 to 6. Of 33 530 patients (female, 40.6%; mean age, 68.8±13.3 years) who had an AIS, PP upon admission had a reverse J-curve association with an unfavorable outcome. After adjusting for clinical variables, including AIS subtypes, initial National Institutes of Health Stroke Scale, and systolic and diastolic blood pressure upon admission, a PP of <50 mm Hg was associated with unfavorable outcomes (P<0.0001). Compared with patients with a PP of 50 to 69 mm Hg, the odds ratios for unfavorable outcomes were 1.24 (95% CI, 1.14-1.36) with a PP of 30 to 49 mm Hg and 1.85 (95% CI, 1.50-2.28) with a PP of <30 mm Hg. Moreover, the prognostic impact of PP upon admission was similar across all AIS subtypes.

Conclusions

Low PP upon admission was associated with unfavorable patient outcomes in AIS.

SUBMITTER: Tang SC 

PROVIDER: S-EPMC5669158 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Low Pulse Pressure After Acute Ischemic Stroke is Associated With Unfavorable Outcomes: The Taiwan Stroke Registry.

Tang Sung-Chun SC   Yin Jiu-Haw JH   Liu Chung-Hsiang CH   Sun Ming-Hui MH   Lee Jiunn-Tay JT   Sun Yu Y   Hsu Chih-Shan CS   Sun Mu-Chien MC   Lin Ching-Huang CH   Chen Chih-Hung CH   Lien Li-Ming LM   Muo Chih-Hsin CH   Jeng Jiann-Shing JS   Hsu Chung Y CY  

Journal of the American Heart Association 20170622 6


<h4>Background</h4>Pulse pressure (PP) is related to cardiac function, arterial stiffness, fluid status, and vascular events. This study aimed to explore the prognostic role of PP upon admission in patients with acute ischemic stroke (AIS) based on a nation-wide stroke registry.<h4>Methods and results</h4>We evaluated the association between PP upon admission and outcomes 3 months after a stroke in patients who had an AIS registered in the Taiwan Stroke Registry, including 56 academic and commun  ...[more]

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