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Makkiyah FA, Dicha S, Nurrizzka RH. A Single-Center Experience of Correlation of Pulse Pressure to Mortality of Stroke Hemorrhage Patients in Indonesia. ScientificWorldJournal 2023; 2023:5517493. [PMID: 37593547 PMCID: PMC10432090 DOI: 10.1155/2023/5517493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/19/2023] Open
Abstract
Introduction The relationship between pulse pressure and mortality in acute stroke hemorrhage patients is a subject of debate. To investigate this relationship in the Indonesian context, a study was conducted due to the increasing prevalence of stroke in the country. Methods The study sample consisted of 111 patients with acute stroke hemorrhage admitted to the hospital between January 1, 2016, and December 31, 2019. Patients with sepsis, cancer, or other hematology disorders were excluded, as were those who were lost to follow-up. Statistical analysis was performed using SPSS 22, and correlations were evaluated between various patient characteristics and laboratory values. Results It was revealed that patients with a wider pulse pressure were more likely to die (adjusted odds ratio = 3,070) than those with a normal or constricted pulse pressure. Conclusion Pulse pressure had an impact on the mortality of patients with acute hemorrhagic stroke.
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Affiliation(s)
- Feda Anisah Makkiyah
- Department of Neurosurgery, Universitas Pembangunan Nasional Veteran Jakarta, Jalan RS Fatmawati No. 1 Pondok Labu, Jakarta 12520, Indonesia
| | - Saraah Dicha
- Department of Neurosurgery, Universitas Pembangunan Nasional Veteran Jakarta, Jalan RS Fatmawati No. 1 Pondok Labu, Jakarta 12520, Indonesia
| | - Rahmah Hida Nurrizzka
- Faculty of Public Health, Universitas Islam Negeri Syarif Hidayatullah Jakarta, Jakarta Selatan, Indonesia
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Armahizer M, Blackman A, Plazak M, Brophy GM. Early Acute Ischemic Stroke Management for Pharmacists. Hosp Pharm 2018; 55:12-25. [PMID: 31983762 DOI: 10.1177/0018578718791504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Wu D, Lyu Y, Zhong P, Liu F, Liu X. Human Urinary kallidinogenase promotes good recovery in ischemic stroke patients with level 3 hypertension. Brain Behav 2017; 7:e00752. [PMID: 28828213 PMCID: PMC5561313 DOI: 10.1002/brb3.752] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/05/2017] [Accepted: 05/15/2017] [Indexed: 01/08/2023] Open
Abstract
AIM To evaluate the clinical efficacy of Human Urinary kallidinogenase (HUK) in the treatment of acute ischemic stroke (AIS) patients with level 3 hypertension. METHODS In this retrospective study, from January 2015 to June 2016, 150 consecutive AIS patients were registered in our database. Among them, 47 with level 3 hypertension received either HUK treatment (HUK group, 22 cases) or basic treatment (control group, 25 cases). Basic treatment was administrated on all patients. 0.15 PNA unit of HUK injection plus 100 ml saline in intravenous infusion was performed in the HUK group, with once a day for 14 consecutive days. The modified Rankin Scale (mRS) scores in two groups were analyzed 3 months after the treatment. RESULTS No difference was found in the NIHSS scores, age, gender, and comorbidities between two groups before treatment (p > .05). While after treatment, 3-month mRS score was significantly lower in the HUK group (2.1 ± 1.4 vs. 3.1 ± 1.3, p = .012) and good recovery rate (3-month mRS score ≤2) in the HUK group was significantly higher than that in the control group (p < .05). CONCLUSION HUK is able to promote long-term recovery for AIS patients with level 3 hypertension remarkably.
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Affiliation(s)
- Danhong Wu
- Department of Neurology Shanghai Fifth People's Hospital Fudan University Shanghai China
| | - Yi Lyu
- Department of Medical Affairs Techpool Bio-pharma Co.; Ltd. Guangzhou China
| | - Ping Zhong
- Department of Neurology Shanghai TCM Integrated Hospital Affiliated Shanghai University of Chinese Medicine Shanghai China
| | - Fengdi Liu
- Department of Medical Affairs Techpool Bio-pharma Co.; Ltd. Guangzhou China
| | - Xueyuan Liu
- Department of Neurology Shanghai Tenth People's Hospital of Tongji University Shanghai China
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Tang SC, Yin JH, Liu CH, Sun MH, Lee JT, Sun Y, Hsu CS, Sun MC, Lin CH, Chen CH, Lien LM, Muo CH, Jeng JS, Hsu CY. Low Pulse Pressure After Acute Ischemic Stroke is Associated With Unfavorable Outcomes: The Taiwan Stroke Registry. J Am Heart Assoc 2017. [PMID: 28642220 PMCID: PMC5669158 DOI: 10.1161/jaha.116.005113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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.
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Affiliation(s)
- Sung-Chun Tang
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jiu-Haw Yin
- Department of Neurology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Chung-Hsiang Liu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Ming-Hui Sun
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, Taipei, Taiwan
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Chih-Shan Hsu
- Department of Neurology, China Medical University Beigang Hospital, Taichung, Taiwan
| | - Mu-Chien Sun
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Ching-Huang Lin
- Department of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chih-Hung Chen
- Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Li-Ming Lien
- Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Jiann-Shing Jeng
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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Mistry EA, Mistry AM, Nakawah MO, Khattar NK, Fortuny EM, Cruz AS, Froehler MT, Chitale RV, James RF, Fusco MR, Volpi JJ. Systolic Blood Pressure Within 24 Hours After Thrombectomy for Acute Ischemic Stroke Correlates With Outcome. J Am Heart Assoc 2017; 6:JAHA.117.006167. [PMID: 28522673 PMCID: PMC5524120 DOI: 10.1161/jaha.117.006167] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Current guidelines suggest treating blood pressure above 180/105 mm Hg during the first 24 hours in patients with acute ischemic stroke undergoing any form of recanalization therapy. Currently, no studies exist to guide blood pressure management in patients with stroke treated specifically with mechanical thrombectomy. We aimed to determine the association between blood pressure parameters within the first 24 hours after mechanical thrombectomy and patient outcomes. Methods and Results We retrospectively studied a consecutive sample of adult patients who underwent mechanical thrombectomy for acute ischemic stroke of the anterior cerebral circulation at 3 institutions from March 2015 to October 2016. We collected the values of maximum, minimum, and average values of systolic blood pressure, diastolic blood pressure, and mean arterial pressures in the first 24 hours after mechanical thrombectomy. Primary and secondary outcomes were patients’ functional status at 90 days measured on the modified Rankin scale and the incidence and severity of intracranial hemorrhages within 48 hours. Associations were explored using an ordered multivariable logistic regression analyses. A total of 228 patients were included (mean age 65.8±14.3; 104 males, 45.6%). Maximum systolic blood pressure independently correlated with a worse 90‐day modified Rankin scale and hemorrhagic complications within 48 hours (adjusted odds ratio=1.02 [1.01–1.03], P=0.004; 1.02 [1.01–1.04], P=0.002; respectively) in multivariable analyses, after adjusting for several possible confounders. Conclusions Higher peak values of systolic blood pressure independently correlated with worse 90‐day modified Rankin scale and a higher rate of hemorrhagic complications. Further prospective studies are warranted to identify whether systolic blood pressure is a therapeutic target to improve outcomes.
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Affiliation(s)
- Eva A Mistry
- Department of Neurology, Houston Methodist Neurological Institute, Houston, TX
| | | | | | - Nicolas K Khattar
- Department of Neurosurgery, University of Louisville School of Medicine, Louisville, KY
| | - Enzo M Fortuny
- Department of Neurosurgery, University of Louisville School of Medicine, Louisville, KY
| | - Aurora S Cruz
- Department of Neurosurgery, University of Louisville School of Medicine, Louisville, KY
| | - Michael T Froehler
- Cerebrovascular Program, Vanderbilt University Medical Center, Nashville, TN
| | - Rohan V Chitale
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN
- Cerebrovascular Program, Vanderbilt University Medical Center, Nashville, TN
| | - Robert F James
- Department of Neurosurgery, University of Louisville School of Medicine, Louisville, KY
| | - Matthew R Fusco
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN
- Cerebrovascular Program, Vanderbilt University Medical Center, Nashville, TN
| | - John J Volpi
- Department of Neurology, Houston Methodist Neurological Institute, Houston, TX
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