AUTHOR=Liu Bai-Jun , Li Jing , Chen Hui-Sheng 

TITLE=Age and sex affect the association of systolic blood pressure with clinical outcomes in thrombolysed stroke patient: a secondary analysis of the INTRECIS study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1273131

DOI=10.3389/fneur.2023.1273131

ISSN=1664-2295

ABSTRACT=Background and purpose: Blood pressure is associated with outcome in acute ischemic stroke (AIS) patients receiving intravenous alteplase. We aimed to explore the effect of sex and age on their association.Based on a prospective cohort, we retrospectively enrolled consecutive AIS patients who received intravenous alteplase and had complete blood pressure data, including baseline systolic blood pressure (SBP 01), SBP at 1 hour (SBP 02), and SBP at 24 hours (SBP 03) after alteplase. Maximum SBP (SBP max), minimum SBP (SBP min), and mean SBP (SBP mean) were calculated. Poor outcome was defined as modified Rankin Scale (mRS) score 2-6 at 90 days. We explored the effect of age and sex on the association of different SBP indicators with the 3-month outcomes.Results: A total of 1593 eligible patients were included in the present study. All SBP indicators were found to be higher in patients with poor vs good outcome. Multivariate logistic regression analysis showed that all SBP indicators except baseline SBP were associated with poor outcome with good prediction powers (AUC 0.762-0.766). More SBP indicators (SBP 02, SBP 03, SBP min and SBP mean) were associated with poor outcome in women vs men, while all SBP indicators after alteplase were associated with poor outcome in patients aged ≥60 years, but none in patients aged < 60 years.Furthermore, all SBP indicators after alteplase were associated with poor outcome in women aged ≥60 years, while only SBP 03 in men aged < 60 years.Conclusions: Among Chinese stroke patients treated with intravenous alteplase, SBP 4 after alteplase was associated with clinical outcome, which was affected by age and sex.