London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 327 89 Stroke prognosis Reduced kidney function and clinical outcomes after ischemic stroke among patients with atri-al fibrillation D.R. Wang1, M. Liu2, Z.L. Hao3 West China Hospital, Sichuan University, Chengdu, CHINA1, West China Hospital, Sichuan University, Chengdu, CHINA2, West China Hospital, Sichuan University, Chengdu, CHINA3 Background and Purpose Chronic kidney disease was associated with an increased risk of stroke among patients with atrial fibrillation. However, observational data on the association between reduced renal function and out-come or recurrence of ischemic stroke with atrial fibrillation is scarce. We aimed to investigate the influence of reduced renal function on functional outcome and recurrence of acute ischemic stroke patients with atrial fibrillation in a hospitalized Chinese population. Methods We prospectively enrolled consecutive patients with acute ischemic stroke and atrial fibrillation who were admitted within one month of stroke onset from January, 2003 to February, 2007 into the anal-ysis. Clinical characteristics such as age, gender, risk factors, National Institutes of Health Stroke Scale (NIHSS) on admission were investigated. Basic characteristics, functional outcomes and re-currence were compared between reduced eGFR group and non-reduced eGFR group. Results Of the 229 cases included, reduced eGFR was present in 105 patients (45.9%). Patients with reduced eGFR, compared with those with non-reduced eGFR, were more frequently female and had a sig-nificantly lower proportion of alcohol consumption and current smoking (all P</=0.002). After ad-justment, the death risk in patients with reduced eGFR was about 2-fold higher at three months, six months and one year compared to patients with non-reduced eGFR (all P</=0.042). Compared with patients with non-reduced eGFR, those with reduced eGFR showed no significantly difference for cumulative recurrence rate by one year cumulative recurrent curves (p =0.331, log rank test). Conclusions Reduced eGFR was independently associated with an increased risk of death for ischemic stroke with atrial fibrillation, but seemed not to be significantly associated with an increased risk of recur-rence. 90 Stroke prognosis Predictive role of time rate of blood pressure variation on stroke outcome at 1-year. P. Zis1, K. Spengos2, K. Vemmos3, E. Manios4, V. Zis5, M.A. Dimopoulos6, N. Zakopoulos7 Department of Clinical Therapeutics, University of Athens, London, GREECE1, Department of Neurology, University of Athens, Athens, GREECE2, Department of Clinical Therapeutics, Univer-sity of Athens, Athens, GREECE3, Department of Clinical Therapeutics, University of Athens, Ath-ens, GREECE4, Department of Neurology, University of Athens, Athens, GREECE5, Department of Clinical Therapeutics, University of Athens, Athens, GREECE6, Department of Clinical Therapeu-tics, University of Athens, Athens, GREECE7 Background Time rate of blood pressure (BP) variation is a measure of the speed of BP fluctua-tions derived from a computerized analysis of ambulatory blood pressure monitoring. Our aim was to investigate the impact of time rate of BP variation in outcome at 1 year post-stroke. Methods A consecutive series of 109 first-ever stroke patients, underwent 24-hour ambulatory BP monitoring within 24 hours after stroke onset. Based on the subjects’ modified Rankin Scale score at 1 year af-ter stroke, the study population was divided into two groups: patients with a positive (mRS≤2) or a negative outcome (mRS≥3). Results At 1 year, 73 patients had a positive. No patients were lost to follow up. Those with a negative outcome (n=36) had higher NIHSS scores at admission, had suf-fered less frequently an ischemic stroke, were more likely to have a history of diabetes mellitus and presented higher heart rate, higher SBP variability and higher time rate of SBP variation. The fol-lowing independent variables were entered into the multivariate logistic regression model: history of diabetes mellitus, hemorrhagic stroke event, 24-hour HR, 24-hour SBP variability, 24-hour rate of SBP variation and NIHSS score at admission. Having a history of diabetes mellitus was associated with a 2.77 fold increase in the odds of a negative outcome (95% CI 1.04 – 7.37), having suffered an intracerebral hemorrhage was associated with a 3.67 fold increase in the odds of a negative outcome (95% CI 1.01 – 13.38),each increased point in the NIHSS score was associated with a 1.15 increase in the odds of a negative outcome (95% CI 1.01 – 1.31) and a 0.1mmHg/min increase in the 24-h rate of SBP variation was associated with a 1.96 fold increase in the odds of a negative outcome (95% CI 1.16 – 3.32). Conclusion Time rate of BP variation is associated with outcome at 1-year. Lowering the time rate of BP variation, in the acute phase, might offer better outcomes in patients who suffered a cerebrovascular incident.
Karger_ESC London_2013
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