Abstract 38: Magnitude Of Blood Pressure Change After Endovascular Therapy And Outcomes: Insight From Bp Target Trial

Background:To assess the association between systolic blood pressure change (ΔSBP) at different time intervals after successful reperfusion with radiographic and clinical outcomes.Methods:This is a post hoc analysis of the Safety and efficacy of intensive blood pressure lowering after successful endovascular therapy in acute ischaemic stroke (BP TARGET) multicenter trial. ΔSBP was defined as end of procedure SBP minus mean SBP at different time intervals (15-60 minutes, 1-6 hours, 6-24 hours post-procedure). The primary outcome was the poor functional outcome (90-day modified Rankin Scale 3-6).Results:We included a total of 267 patients (130 in the intensive treatment group). Compared to patients with favorable outcome, patients with poor outcome had lower ΔSBP (less SBP reduction) at all times intervals. After adjusting for potential confounders including baseline SBP, both ΔSBP15-60Mand ΔSBP6-24Hwere associated with lower odds of poor outcome (adjusted odds ratio [aOR] per 5mmHg SBP reduction, 0.89; 95% confidence interval [CI] 0.81 to 0.99, and aOR 0.82; 95% CI 0.73 to 0.92, respectively). Concerning safety outcomes, patients with intraparenchymal hemorrhage (IPH) had lower ΔSBP at all time intervals. ΔSBP15-60Mwas associated with lower odds of any IPH (aOR per 5mmHg SBP reduction 0.91, 95% CI 0.83 to 0.99). Conversely, ΔSBP was not associated with mortality or neurological deterioration at any time interval.Conclusion:After successful reperfusion, ΔSBP had a linear relationship with poor outcome and the risk of poor outcome was higher with less reduction from the baseline SBP.