Dongjing Xie,1,* Junfang Wan,2,3,* Changwei Guo,1 Jie Yang,1 Jiacheng Huang,1 Zhouzhou Peng,1 Jiandi Huang,1 Linyu Li,1 Shitao Fan,1 Dahong Yang,1 Wenzhe Sun,1 Wenjie Zi,1 Fengli Li,1 Feng Peng,4 Jinrong Hu,1 Qingwu Yang1 

1Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China; 2Department of Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Anesthesiology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China; 4Department of Neurology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Qingwu Yang; Jinrong Hu, Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), No. 183 Xinqiao Main Street, Shapingba District, Chongqing, 400037, People’s Republic of China, Tel +86 23 68774270 ; +86 15183089810, Email yangqwmlys@tmmu.edu.cn; hujinrong1108@163.com

Background and Purpose: Many patients who gained successful recanalization by endovascular treatment (EVT) with acute large vessel occlusion (LVO) did not have the favorable outcome. The study aimed to assess the association between H-type hypertension and clinical prognosis in patients with LVO after receiving EVT.
Methods: Our study enrolled patients from the Endovascular Treatment With versus Without Tirofiban for Stroke Patients with Large Vessel Occlusion (RESCUE BT) Trial. H-type hypertension is defined as patients with hypertension and homocysteine (Hcy) ≥ 10μmol/L. The primary outcome was a favorable functional outcome, defined as a score of 0– 2 on the modified Rankin Scale (mRS) at 90 days. The secondary outcomes were mortality, successful recanalization, futile recanalization, and symptomatic intracerebral hemorrhage (sICH).
Results: The plasma homocysteine level was recorded for 215 patients with hypertension in our study. Among those patients, 172 patients (80%) were founded with Hcy ≥ 10μmol/L (H-type hypertension), and 43 patients (20%) with Hcy < 10μmol/L (non-H-type hypertension). The probability of favorable outcome decreased with homocysteine increasing in patients with hypertension. H-type hypertension was associated with a low probability of favorable outcome (adjusted odds ratio (aOR), 0.38 [95% confidence interval (CI), 0.18– 0.80]; p = 0.01) at 90 days. The effects of H-type hypertension on mortality (aOR, 1.90 [95% CI, 0.67– 5.39]; p = 0.23) and sICH (aOR, 0.55 [95% CI, 0.13– 2.29]; p = 0.41) were not significant.
Conclusion: Our findings suggest that patients with H-type hypertension have a lower likelihood of achieving favorable outcomes but do not have an increased mortality rate within 90 days.

Keywords: H-type hypertension, clinical prognoses, large vessel occlusion