{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:13:24Z","timestamp":1783944804774,"version":"3.55.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,4,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">We investigated whether the association between blood pressure (BP) management in patients with successful reperfusion following endovascular therapy (EVT) and functional outcomes is mediated by BP variability parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This is a post hoc analysis of the OPTIMAL\u2010BP (Outcome in Patients Treated With Intra\u2010Arterial Thrombectomy\u2010Optimal Blood Pressure Control) trial, conducted at 19 centers in South Korea. The primary outcome was the 90\u2010day functional outcome, assessed using the modified Rankin Scale. Multivariable logistic regression analysis was conducted for the association between BP variability and outcomes including 90\u2010day modified Rankin Scale score, symptomatic intracranial hemorrhage, and final infarction volume. Mediation analysis was performed to evaluate the causal inference whether the relationship between intensive BP management and the 90\u2010day modified Rankin Scale scoreis mediated by 24\u2010hour BP variability parameters (time rate [TR], SD, coefficient of variation, and variability independent of the mean). Among various BP variability parameters, higher TR was associated with an unfavorable ordinal shift of the 90\u2010day modified Rankin Scale score (adjusted odds ratio [aOR], 1.17 [95% CI, 1.04\u20131.32],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.007) and an increase in final infarction volume (\n                      <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                        <mml:semantics>\n                          <mml:mrow>\n                            <mml:mi>\u03b2<\/mml:mi>\n                          <\/mml:mrow>\n                          <mml:annotation encoding=\"application\/x-tex\">$$ \\beta $$<\/mml:annotation>\n                        <\/mml:semantics>\n                      <\/mml:math>\n                      coefficient, 21.24 [95% CI, 3.99\u201338.48],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.016), but did not increase the risk of symptomatic intracranial hemorrhage. TR fully mediated the association between intensive BP management and functional outcomes. The proportion of the association explained by TR was 40.93%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">TR mediated the relationship between intensive BP management and poor functional outcome in successfully reperfused patients with ischemic stroke by contributing to an increase in infarct volume. Efforts to modulate TR after EVT may be helpful in improving clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.039723","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T23:19:10Z","timestamp":1744067950000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Mediation of Time\u2010Related Blood Pressure Variability on Intensive Blood Pressure Lowering and Functional Outcomes Post Endovascular Therapy: A Post Hoc Analysis of the OPTIMAL\u2010BP Trial"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4880-9258","authenticated-orcid":false,"given":"Jun Young","family":"Chang","sequence":"first","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8641-3786","authenticated-orcid":false,"given":"Jae Young","family":"Park","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4992-1065","authenticated-orcid":false,"given":"Jeong Yun","family":"Song","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2033-1002","authenticated-orcid":false,"given":"Jun Sang","family":"Yoo","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3372-9158","authenticated-orcid":false,"given":"Kyu Bong","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9219-8522","authenticated-orcid":false,"given":"Jae Wook","family":"Jung","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-3462","authenticated-orcid":false,"given":"Ji Sung","family":"Lee","sequence":"additional","affiliation":[{"name":"Asan Medical Center","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-2616","authenticated-orcid":false,"given":"Young Dae","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8593-6841","authenticated-orcid":false,"given":"Byung Moon","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bang\u2010Hoon","family":"Cho","sequence":"additional","affiliation":[{"name":"Korea University Anam Hospital and College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4778-491X","authenticated-orcid":false,"given":"Seong Hwan","family":"Ahn","sequence":"additional","affiliation":[{"name":"Chosun University School of Medicine","place":["Gwangju, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6900-1242","authenticated-orcid":false,"given":"Sung\u2010Il","family":"Sohn","sequence":"additional","affiliation":[{"name":"Keimyung University School of Medicine","place":["Daegu, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9937-762X","authenticated-orcid":false,"given":"Tae\u2010Jin","family":"Song","sequence":"additional","affiliation":[{"name":"Ewha Woman\u2019s University, College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0345-2278","authenticated-orcid":false,"given":"Yoonkyung","family":"Chang","sequence":"additional","affiliation":[{"name":"Ewha Woman\u2019s University, College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3154-8864","authenticated-orcid":false,"given":"Kwon\u2010Duk","family":"Seo","sequence":"additional","affiliation":[{"name":"National Health Insurance Service Ilsan Hospital","place":["Goyang, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5551-0273","authenticated-orcid":false,"given":"Sukyoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Inje University College of Medicine","place":["Busan, South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6733-0683","authenticated-orcid":false,"given":"Jang\u2010Hyun","family":"Baek","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["Seoul, 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Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1418-0033","authenticated-orcid":false,"given":"Jae Guk","family":"Kim","sequence":"additional","affiliation":[{"name":"Eulji University School of Medicine","place":["Daejon, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun U.","family":"Kwon","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7962-8751","authenticated-orcid":false,"given":"Oh Young","family":"Bang","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9898-3321","authenticated-orcid":false,"given":"Ji Hoe","family":"Heo","sequence":"additional","affiliation":[{"name":"Yonsei 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