Low Pulse Pressure After Acute Ischemic Stroke is Associated With Unfavorable Outcomes

The Taiwan Stroke Registry

Taiwan Stroke Registry Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish
JournalJournal of the American Heart Association
Volume6
Issue number6
DOIs
Publication statusPublished - Jun 22 2017
Externally publishedYes

Fingerprint

Taiwan
Registries
Stroke
Blood Pressure
Vascular Stiffness
Patient Admission
Community Hospital
National Institutes of Health (U.S.)
Blood Vessels
Odds Ratio

Keywords

  • blood pressure
  • ischemic stroke
  • outcome
  • pulse pressure
  • stroke registry

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Low Pulse Pressure After Acute Ischemic Stroke is Associated With Unfavorable Outcomes : The Taiwan Stroke Registry. / Taiwan Stroke Registry Investigators.

In: Journal of the American Heart Association, Vol. 6, No. 6, 22.06.2017.

Research output: Contribution to journalArticle

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title = "Low Pulse Pressure After Acute Ischemic Stroke is Associated With Unfavorable Outcomes: The Taiwan Stroke Registry",
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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author = "{Taiwan Stroke Registry Investigators} and Tang, {Sung Chun} and Yin, {Jiu Haw} and Liu, {Chung Hsiang} and Sun, {Ming Hui} and Lee, {Jiunn Tay} and Yu Sun and Hsu, {Chih Shan} and Sun, {Mu Chien} and Lin, {Ching Huang} and Chen, {Chih Hung} and Lien, {Li Ming} and Muo, {Chih Hsin} and Jeng, {Jiann Shing} and Hsu, {Chung Y.}",
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AU - Tang, Sung Chun

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AU - Liu, Chung Hsiang

AU - Sun, Ming Hui

AU - Lee, Jiunn Tay

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AU - Hsu, Chih Shan

AU - Sun, Mu Chien

AU - Lin, Ching Huang

AU - Chen, Chih Hung

AU - Lien, Li Ming

AU - Muo, Chih Hsin

AU - Jeng, Jiann Shing

AU - Hsu, Chung Y.

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N2 - 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.

AB - 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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