The impact of hypertension on clinical outcomes in moyamoya disease: a multicenter, propensity score-matched analysis.
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Musmar Basel, Roy Joanna M, Abdalrazeq Hammam, Atallah Elias, Naamani Kareem El, Chen Ching-Jen, Jabre Roland, Saad Hassan, Grossberg Jonathan A, Dmytriw Adam A, Patel Aman B, Khorasanizadeh Mirhojjat, Ogilvy Christopher S, Thomas Ajith J, Monteiro Andre, Siddiqui Adnan, Cortez Gustavo M, Hanel Ricardo A, Porto Guilherme, Spiotta Alejandro M, Piscopo Anthony J, Hasan David M, Ghorbani Mohammad, Weinberg Joshua, Nimjee Shahid M, Bekelis Kimon, Salem Mohamed M, Burkhardt Jan-Karl, Zetchi Akli, Matouk Charles, Howard Brian M, Lai Rosalind, Du Rose, Abbas Rawad, Sioutas Georgios S, Amllay Abdelaziz, Munoz Alfredo, Herial Nabeel A, Tjoumakaris Stavropoula I, Gooch Michael Reid, Rosenwasser Robert H, Jabbour Pascal
Аннотация
METHODS: We conducted a multicenter, retrospective study involving 598 MMD patients who underwent surgical revascularization across 13 academic institutions in North America. Patients were categorized into hypertensive (n=292) and non-hypertensive (n=306) cohorts. Propensity score matching (PSM) was performed to adjust for baseline differences.
RESULTS: The mean age was higher in the hypertension group (46 years vs. 36.8 years, p < 0.001). Hypertensive patients had higher rates of diabetes mellitus (45.2% vs. 10.7%, p < 0.001) and smoking (48.8% vs. 27.1%, p < 0.001). Symptomatic stroke rates were higher in the hypertension group (16% vs. 7.1%; OR: 2.48; 95% CI: 1.39-4.40, p = 0.002) before matching. After PSM, there were no significant differences in symptomatic stroke rates (11.1% vs. 7.7%; OR: 1.5; CI: 0.64-3.47, p = 0.34), perioperative strokes (6.2% vs. 2.1%; OR 3.13; 95% CI: 0.83-11.82, p = 0.09), or good functional outcomes at discharge (93% vs. 92.3%; OR 1.1; 95% CI: 0.45-2.69, p = 0.82).
CONCLUSION: No significant differences in symptomatic stroke rates, perioperative strokes, or functional outcomes were observed between hypertensive and non-hypertensive Moyamoya patients. Appropriate management can lead to similar outcomes in both groups. Further prospective studies are required to validate these findings.