BP-TARGET
Trial question
What is the role of intensive SBP target after successful endovascular therapy in AIS?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
52.0% female
48.0% male
N = 318
318 patients (165 female, 153 male).
Inclusion criteria: adult patients with an AIS due to a large-vessel occlusion that was successfully treated with endovascular therapy.
Key exclusion criteria: per-procedure hemorrhagic complications; SBP at baseline < 130 mmHg within 1 hour of recanalization; pre-existing stroke disability defined by a mRS score > 2.
Interventions
N=158 intensive SBP target (SBP target of 100-129 mmHg).
N=160 standard SBP target (SBP target of 130-185 mmHg).
Primary outcome
Radiographic intraparenchymal hemorrhage at 24-36 hours
42%
43%
43.0 %
32.3 %
21.5 %
10.8 %
0.0 %
Intensive systolic blood pressure
target
Standard systolic blood pressure
target
No significant
difference ↔
No significant difference in radiographic intraparenchymal hemorrhage at 24-36 hours (42% vs. 43%; OR 0.96, 96% CI 0.6 to 1.51).
Secondary outcomes
No significant difference in favorable outcome at 3 months (44% vs. 45%; OR 0.93, 95% CI 0.58 to 1.48).
No significant difference in excellent outcome at 3 months (32% vs. 28%; OR 1.2, 95% CI 0.72 to 1.97).
No significant difference in reduction in NIHSS score at 24-36 hours (4.1 points vs. 4.4 points; AD -0.3 points, 95% CI -1.7 to 2.3).
Safety outcomes
No significant differences in all-cause mortality, parenchymal hematoma type 2 at 24-36 hours.
Significant difference in hypotension (8% vs. 3%).
Conclusion
In adult patients with an AIS due to a large-vessel occlusion that was successfully treated with endovascular therapy, intensive SBP target was not superior to standard SBP target with respect to radiographic intraparenchymal hemorrhage at 24-36 hours.
Reference
Mikael Mazighi, Sebastien Richard, Bertrand Lapergue et al. Safety and efficacy of intensive blood pressure lowering after successful endovascular therapy in acute ischaemic stroke (BP-TARGET): a multicentre, open-label, randomised controlled trial. Lancet Neurol. 2021 Apr;20(4):265-274.
Open reference URL