| Background and Objective: Acute ischemic stroke is characterized by high morbidity,high mortality and high recurrence rate,which seriously affects the health of patients.Endovascular treatment（EVT）is the recommended treatment for acute ischemic stroke with large vessel occlusion in China guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2018,but the good prognosis（m RS 0-2 points）at 3 months after EVT is only 32.6-71%.Finding prognostic targets for EVT patients and carrying out targeted intervention are feasible directions to improve EVT efficacy.Beat-to-beat blood pressure variability refers to the variability of blood pressure generated by each beat of the heart within a specified time.Studies have confirmed that beat-tobeat blood pressure variability is closely related to the recurrence of stroke and cardiovascular events.However,the characteristics of beat-to-beat blood pressure variability in patients undergoing endovascular treatment for acute ischemic stroke remain unclear.Therefore,the purpose of this study was to analyze the correlation between beat-to-beat blood pressure variability and prognosis in patients with acute ischemic stroke after endovascular treatment at 7 days after operation.Methods: Retrospective data were collected from acute ischemic stroke patients with large vessel occlusion treated in the First Hospital of Jilin University from June 2014 to December 2020 and received endovascular treatment within 24 h of onset.Patients with acute ischemic stroke accompanied by large vessel occlusion during the same period without endovascular treatment were classified as 1: 1,matched by age and sex,was included in the study as the control group.Non-invasive fingertip blood pressure monitor was used to monitor fingertip blood pressure for 5 minutes within 7 days after onset,and the standard deviation（SD）and average real variability（ARV）of systolic blood pressure,diastolic blood pressure and mean arterial blood pressure was calculated to measure beat-to-beat blood pressure variability.The modified Rankin scale（m RS）score ≤2 points at 3 months of telephone follow-up was defined as a good prognosis.Multivariate Logistic regression was used to analyze the relationship between beat-to-beat blood pressure variability and clinical prognosis.Results: A total of 67 endovascular treatment（EVT）patients,with an average age of 57.36±11.78 years,were included,including 58（86.6%）males.The 67 patients with acute ischemic stroke without endovascular treatment（Non-EVT）were included as the control group in a 1:1 ratio according to age and sex,with an average age of 59.58±12.07 years and 61（91.0%）males.There was no significant difference in beat-to-beat blood pressure variability between EVT and non-EVT groups.In the EVT group,46 patients（69%）had a good outcome（m RS 0-2）and 21 patients（31%）had a poor outcome（m RS 3-5 or death）.Diabetes mellitus（8.7% vs 42.9%,P=0.007）,time from onset to femoral artery puncture [295.0（218.8-505.0）vs 420.0（355.0-702.5）,P=0.04]and systolic beat-to-beat blood pressure-ARV [2.15（1.40-2.60）mm Hg vs 2.79（1.93-4.01）mm Hg,P=0.011] were significantly different.Finally,Logistic regression analysis showed that systolic beat-to-beat blood pressure-ARV was independently associated with poor prognosis after endovascular treatment（adjusted OR: 2.601,95%CI: 1.240-5.458,P=0.011）.Conclusions: 1.Emergency endovascular treatment did not significantly affect beat-to-beat blood pressure variability in acute ischemic stroke patients.2.The beat-to-beat blood pressure variability within 7 days after endovascular treatment was independently associated with poor outcomes at 3 months.3.The beat-to-beat blood pressure variability within 7 days after endovascular treatment in acute ischemic stroke patients may be a clinically feasible intervention target to improve prognosis. |
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