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Prognostic significance of acute hypertensive response in ischemic stroke or transient ischemic attack patients and its relationship with left ventricular myocardial function

Title
Prognostic significance of acute hypertensive response in ischemic stroke or transient ischemic attack patients and its relationship with left ventricular myocardial function
Authors
Yi, Jeong-EunChang, YoonkyungSong, Tae-JinShin, Gil JaKim, Yong-Jae
Ewha Authors
신길자송태진장윤경
SCOPUS Author ID
신길자scopus; 송태진scopus
Issue Date
2019
Journal Title
JOURNAL OF HYPERTENSION
ISSN
0263-6352JCR Link

1473-5598JCR Link
Citation
JOURNAL OF HYPERTENSION vol. 37, no. 12, pp. 2345 - 2353
Keywords
acute hypertensive responseacute ischemic strokeleft ventricular global longitudinal strainmajor adverse cardiovascular and cerebrovascular eventstransient ischemic attack
Publisher
LIPPINCOTT WILLIAMS &

WILKINS
Indexed
SCI; SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Objectives: Acute hypertensive response (AHR) in acute stroke is associated with adverse outcomes; however, the underlying pathophysiology of the association is poorly understood and its prognostic impact in ischemic stroke remains unclear. We aimed to investigate the prognostic significance of AHR in patients with ischemic stroke or transient ischemic attack (TIA), and further examined the relationship between AHR and myocardial function, using two-dimensional speckle-tracking echocardiography (2D-STE). Methods: A total of 244 consecutive patients with acute ischemic stroke (AIS) (n = 192) or TIA (n = 52), who were evaluated with 2D-STE within 7 days from admission, were retrospectively analysed. The primary endpoint was a composite of major adverse cardiovascular and cerebrovascular events (MACCE), including death, myocardial infraction or recurrent ischemic stroke. Results: Among the study population, AHR was observed in 161 (66%) patients. During a mean follow-up of 21.0 +/- 12.5 months, 29 patients (11.9%) [25 (15.5%) AHR vs. 4 (4.8%) No AHR, P=0.0141 reached the primary endpoint. A Kaplan-Meier curve revealed that patients with AHR had a significantly higher incidence of MACCE than those without AHR (log-rank P=0.013). Multivariate Cox regression analysis demonstrated that AHR [adjusted hazard ratio 4.60, 95% confidence interval (95% CI) 1.31-16.15] was a strong predictor of MACCE. In multivariate logistic regression analysis, left ventricular global longitudinal strain (per 1% decrease) showed a significant relationship with AHR (adjusted odds ratio 1.17, 95% CI 1.02-1.35). Conclusion: AHR in patients with AIS or TIA may be an important poor prognostic marker related to myocardial dysfunction.
DOI
10.1097/HJH.0000000000002171
Appears in Collections:
의과대학 > 의학과 > Journal papers
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