[en] [en] BACKGROUND: The Safety and Efficacy of Intensive Blood Pressure Lowering after Successful Endovascular Therapy in Acute Ischaemic Stroke (BP TARGET) trial demonstrated no benefit from intensive systolic blood pressure (SBP) treatment after successful reperfusion with endovascular therapy. However, it remains unknown if the response to blood pressure treatment is modified by other factors.
OBJECTIVE: To carry out a post hoc analysis of the BP TARGET trial data to determine if the response to blood pressure treatment is modified by factors such as age, history of hypertension, recanalization status, location of occlusion, diabetes, hyperglycemia, or pretreatment with intravenous thrombolysis.
METHODS: This is a post hoc analysis of the BP TARGET trial. Patients were divided into groups based on age, diabetes, blood glucose, site of occlusion, history of hypertension, and pretreatment with intravenous thrombolysis. The primary outcome was any intraparenchymal hemorrhage.
RESULTS: 318 patients were included. Diabetes modified the treatment effect on favorable functional outcome (Pheteogenity=0.041). There was a trend towards benefit from intensive SBP treatment in diabetic patients (OR=2.81; 95% CI 0.88 to 8.88; p=0.08) but not in non-diabetic patients (OR=0.75; 95% 0.45 to 126; p 0.28). Age, location of occlusion, admission SBP, pretreatment with intravenous thrombolysis, and history of hypertension did not modify the effect of intensive SBP treatment on any of the outcomes.
CONCLUSION: The effect of SBP lowering treatment was not modified by age, location of occlusion history of hypertension, intravenous thrombolysis, and admission SBP. Diabetes modified the effect of intensive SBP lowering treatment, and there was a trend towards benefit from intensive SBP treatment in diabetic patients. This finding is hypothesis generating and requires further validation.
Disciplines :
Neurology
Author, co-author :
Anadani, Mohammad ; Neurosurgery, Medical University of South Carolina, Charleston, SC, USA mmazighi@for.paris anadani@musc.edu
Maier, Benjamin; Department of Interventional Neuroradiology, Adolphe de Rothschild Ophthalmological Foundation, Paris, France
Escalard, Simon; Departement of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France
Labreuche, Julien; Univ. Lille, CHU Lille, ULR 2694-METRICS, Lille, France
de Havenon, Adam ; Department of Neurology, Yale University, New Haven, Connecticut, USA
Sabben, Candice; Department of Neurology, Fondation Rothschild Hospital, paris, France
Lapergue, Bertrand; Hospital Foch, Suresnes, Île-de-France, France
Mistry, Eva A; Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Gory, Benjamin; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, Lorraine, France
Spiotta, Alejandro M; Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
Richard, Sébastien ; Neurology Stroke Unit, University Hospital Centre Nancy, Nancy, France
Sibon, Igor; CHU de Bordeaux, Bordeaux, France
Desilles, Jean-Philippe; Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
Blanc, Raphael; Department of Interventional Neuroradiology, Fondation Rothschild, Paris, Île-de-France, France
Piotin, Michel; Departement of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France
Mazighi, Mikaël ; Departement of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France mmazighi@for.paris anadani@musc.edu ; Department of Neurology, GH Lariboisiere Fernand-Widal, Paris, France
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