Safety and efficacy of intensive systolic blood pressure lowering after successful endovascular therapy: a post hoc analysis of the BP TARGET trial.
Blood Pressure
Stroke
Thrombectomy
Journal
Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
07
05
2022
accepted:
28
08
2022
medline:
31
8
2023
pubmed:
12
10
2022
entrez:
11
10
2022
Statut:
ppublish
Résumé
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. 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. 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. 318 patients were included. Diabetes modified the treatment effect on favorable functional outcome (P 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.
Sections du résumé
BACKGROUND
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
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
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
RESULTS
318 patients were included. Diabetes modified the treatment effect on favorable functional outcome (P
CONCLUSION
CONCLUSIONS
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.
Identifiants
pubmed: 36220337
pii: jnis-2022-019130
doi: 10.1136/jnis-2022-019130
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e142-e147Investigateurs
Mikael Mazighi
(M)
Michel Piotin
(M)
Lucas Di Meglio
(LD)
Hocine Redjem
(H)
Benjamin Maïer
(B)
Jean-Philippe Desilles
(JP)
Simon Escalard
(S)
Stanislas Smajda
(S)
François Delvoye
(F)
Solène Hebert
(S)
Michael Obadia
(M)
Candice Sabben
(C)
Alexandre Obadia
(A)
Igor Raynouard
(I)
Erwan Morvan
(E)
Perrine Boursin
(P)
Malek Ben Maacha
(MB)
Bertrand Lapergue
(B)
Arturo Consoli
(A)
Adrien Wang
(A)
Benjamin Gory
(B)
Sebastien Richard
(S)
Gioia Mione
(G)
Lisa Humbertjean
(L)
Matthieu Bonnerot
(M)
Jean-Christophe Lacour
(JC)
René Anxionnat
(R)
Romain Tonnelet
(R)
Serge Bracard
(S)
Xavier Barreau
(X)
Gaultier Marnat
(G)
Jérôme Berge
(J)
Ludovic Lucas
(L)
Pauline Renou
(P)
Sabrina Debruxelles
(S)
Mathilde Poli
(M)
Sharmila Sagnier
(S)
Informations de copyright
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: RB, MP declare institutional fees for teaching presentations from Stryker, MicroVention, Balt; MM declares institutional fees for teaching presentations from Boerhinger Ingelheim, Amgen, and consulting fees from Boerhinger Ingelheim, Air liquide, Acticor Biotech; AdH declares grants from Regeneron Pharmaceuticals, Inc.; grants from AMAG Pharmaceuticals, Inc.; compensation from Integra for consultant services; and stock options in Certus.