To study the association between blood pressure trajectories after endovascular thrombectomy and functional outcome

We retrospectively assembled a cohort of 1060 patients from several centers with anterior large-vessel occlusion stroke and EVT. BP was non-invasively recorded at least hourly for the first 72 hours. Functional outcome was evaluated using the modified Rankin scale (mRS). Favorable functional outcome was defined as mRS <2. Latent variable mixture modeling was used to identify patient subgroups that have similar SBP trajectories. Analyses were adjusted for age, admission NIHSS, and recanalization status.

One thousand sixty patients (mean age 70±15, mean NIHSS 16) were used in the analysis, although more will be included in the final analysis. Five distinct SBP trajectories were observed: (1) low (17%), (2) moderate (38%), (3) moderate-to-high (21%), (4) high-to-moderate (17%), and (5) high (7%). SBP trajectory group independently predicted functional outcome at discharge (p=0.001) and 90 days (p=0.010). Patients with high and high-to-moderate SBP trajectories had a significantly higher odds of an unfavorable outcome at 90 days (adjusted OR 2.3, 95%CI 1.2 – 4.3, p=0.01 and adjusted OR 4, 95% CI 1.5-10.7, p=0.06, respectively).

Acute ischemic stroke patients demonstrate distinct SBP trajectories during the first 72 hours after EVT that differ by functional outcome. These findings may help identify potential candidates for future blood pressure control trials.