Effect of intensive blood pressure control after successful endovascular therapy on outcomes in patients with anterior circulation stroke: a multicentre, open-label, blinded-endpoint, randomized controlled trial
10.3760/cma.j.issn.1673-4165.2023.06.001
- VernacularTitle:成功血管内治疗后强化血压控制对前循环卒中患者转归的影响：多中心、开放标签、终点盲法随机对照试验
- Author:
Chengfang LIU
1
;
Qiwen DENG
;
Hongchao SHI
;
Feng ZHOU
;
Yukai LIU
;
Meng WANG
;
Qiaoyu ZHANG
;
Bingqi ZHANG
;
Min LI
;
Lei PING
;
Tao WANG
;
Haicun SHI
;
Wei WANG
;
Jiankang HOU
;
Shi HUANG
;
Jinfeng LYU
;
Rui SHEN
;
Yingdong ZHANG
;
Junshan ZHOU
Author Information
1. 南京医科大学附属南京医院神经内科，南京 210006
- Keywords:
Ischemic stroke;
Endovascular procedures;
Thrombectomy;
Blood pressure;
Antihypertensive agents;
Treatment outcome;
Randomized controlled trials
- From:
International Journal of Cerebrovascular Diseases
2023;31(6):401-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of intensive and standard blood pressure control on the outcomes of patients with acute ischemic stroke in the anterior circulation who have successfully recanalized after endovascular therapy (EVT).Methods:A multicenter, open-label, blinded-endpoint, randomized controlled design was used. Patients with anterior circulation stroke received EVT and successfully recanalized in Nanjing First Hospital, Nanjing Medical University and several branch hospitals from July 2020 to October 2022 were prospectively included. They were randomly divided into the intensive blood pressure control group (target systolic blood pressure [SBP] 100-120 mmHg) or the standard blood pressure control group (target SBP 121-140 mmHg). The blood pressure of both groups needs to achieve the target within 1 h and maintain for 72 h. The primary outcome endpoint was outcome at 90 d, and the good outcome was defined as a score of 0-2 on the modified Rankin Scale. Secondary outcome endpoints included early neurological improvement, symptomatic intracranial hemorrhage (sICH) within 24 h, and death and serious adverse events within 90 d.Results:A total of 120 patients were included, including 63 in the intensive blood pressure control group and 57 in the standard blood pressure control group. There was no statistically significant difference in baseline characteristics between the two groups. The SBP at 72 h after procedure was 122.7±8.1 mmHg in the intensive blood pressure control group and 130.2±7.4 mmHg in the standard blood pressure control group, respectively. There were no significantly differences in the good outcome rate (54.0% vs. 54.4%; χ2=0.002, P=0.963), the early neurological improvement rate (45.2% vs. 34.5%; χ2=1.367, P=0.242), the incidence of sICH (6.3% vs. 3.5%; P=0.682), mortality (7.9% vs. 14.0%; χ2=1.152, P=0.283) and the incidence of serious adverse events (12.7% vs. 15.8%; χ2=0.235, P=0.628) at 90 d between the intensive blood pressure control group and the standard blood pressure control group. Conclusion:In patients with anterior circulation stroke and successful revascularization of EVT, early intensive blood pressure control don’t improve clinical outcomes and reduce the incidence of sICH.
