Supplementary Material for: The Relationship between Blood Pressure Variability, Recanalization Degree, and Clinical Outcome in Large Vessel Occlusive Stroke after an Intra-Arterial Thrombectomy

Background: Blood pressure variability (BPV) is associated with target organ damage progression and increased cardiovascular events, including stroke. The aim of this study was to evaluate the associations between short-term BPV during acute periods and recanalization degree, early neurological deterioration (END) occurrence, and functional outcomes in acute ischemic stroke patients who had undergone intra-arterial thrombectomy (IAT). Methods: We retrospectively analyzed 303 patients with large vessel occlusive stroke who underwent IAT. The following BPV parameters, measured over 24 and 48 h after IAT, were compared: the mean, SD, coefficient of variation (CV), variation independent of the mean (VIM) for both the systolic BP (SBP) and diastolic BP, and the proportion of nocturnal SBP risers. Results: BPV parameters decreased with higher recanalization degree. The mean SBP (SBPmean) over 24 and 48 h after IAT, and the SD of SBP (SBPSD), CV of SBP (SBPCV), and VIM of SBP (SBPVIM) during the 48 h following the procedure had significant associations with recanalization degree. Patients with END had higher BPV than that of those without END, and the difference was more evident for incomplete recanalization. Increased BPV was associated with a shift toward poor functional outcome at 3 months after adjustment, including recanalization degree (OR range for significant parameters, 1.26–1.64, p = 0.006 for 48 h SBPmean, p = 0.003 for 48 h SBPCV, otherwise p Conclusions: Short-term BPV over 24 and 48 h after IAT in acute ischemic stroke patients was related to recanalization degree, and END occurrence, and may be an independent predictor of clinical outcome.

背景：血压变异性（Blood pressure variability, BPV）与靶器官损害进展及包括卒中在内的心血管事件风险升高相关。本研究旨在探讨接受血管内取栓术（intra-arterial thrombectomy, IAT）的急性缺血性卒中患者，急性期短期血压变异性与血管再通程度、早期神经功能恶化（early neurological deterioration, END）发生情况及功能预后之间的关联。
方法：本研究回顾性分析了303例接受血管内取栓术的大血管闭塞性卒中患者。本研究对比了患者于血管内取栓术后24小时及48小时内监测得到的以下血压变异性参数：收缩压（systolic BP, SBP）与舒张压的均值、标准差（standard deviation, SD）、变异系数（coefficient of variation, CV）、独立于均值的变异度（variation independent of the mean, VIM），以及夜间收缩压升高者占比。
结果：血压变异性参数随血管再通程度升高而呈降低趋势。血管内取栓术后24小时、48小时的平均收缩压（SBPmean），以及术后48小时内的收缩压标准差（SBPSD）、收缩压变异系数（SBPCV）、收缩压独立于均值的变异度（SBPVIM）与血管再通程度存在显著关联。伴早期神经功能恶化（END）的患者其血压变异性水平高于无END者，且该差异在不完全血管再通患者中更为显著。校正包括血管再通程度在内的混杂因素后，血压变异性升高与术后3个月不良功能预后风险升高相关，具有统计学意义的相关参数的比值比（OR）范围为1.26~1.64（术后48小时SBPmean的p=0.006，术后48小时SBPCV的p=0.003，其余参数p
结论：急性缺血性卒中患者接受血管内取栓术后24小时及48小时内的短期血压变异性，与血管再通程度、早期神经功能恶化发生情况密切相关，或可作为临床预后的独立预测因子。