RT Journal Article
SR Electronic
T1 Safety and efficacy of intensive systolic blood pressure lowering after successful endovascular therapy: a post hoc analysis of the BP TARGET trial
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP neurintsurg-2022-019130
DO 10.1136/jnis-2022-019130
A1 Mohammad Anadani
A1 Benjamin Maier
A1 Simon Escalard
A1 Julien Labreuche
A1 Adam de Havenon
A1 Candice Sabben
A1 Bertrand Lapergue
A1 Eva A Mistry
A1 Benjamin Gory
A1 Alejandro M Spiotta
A1 Sébastien Richard
A1 Igor Sibon
A1 Jean-Philippe Desilles
A1 Raphael Blanc
A1 Michel Piotin
A1 Mikaël Mazighi
A1 ,
YR 2022
UL http://jnis.bmj.com/content/early/2022/10/11/jnis-2022-019130.abstract
AB 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.Data are available upon reasonable request.