ENCHANTED2: intensive blood pressure control after successful reperfusion for acute ischemic stroke скачать в хорошем качестве

ENCHANTED2: intensive blood pressure control after successful reperfusion for acute ischemic stroke

Craig Anderson, PhD, University of New South Wales, Sydney, Australia; Lili Song, MD, PhD, The George Institute for Global Health China, Beijing, China; Pengfei Yang, MD, Changhai Hospital, Naval Medical University, Shanghai, China; and Jianmin Liu, MD, Changhai Hospital, Naval Medical University, Shanghai, China, share the findings of the ENCHANTED2 trial (NCT04140110) assessing the safety and effectiveness of intensive blood pressure (BP) lowering after mechanical thrombectomy for acute ischemic stroke. Previous evidence from ENCHANTED (NCT01422616) suggested that intensive BP lowering may reduce intracranial hemorrhage occurrence, but this reduction did not lead to improvements in functional status. ENCHANTED2 therefore aimed to shed light on intensive BP control as a strategy to improve clinical outcomes, assessing functional recovery at 90 days as the primary study endpoint. The trial recruited more than 800 patients with persistent hypertension (systolic BP ≥140mmHg) who underwent successful reperfusion therapy after an acute ischemic stroke due to large vessel occlusion. Participants were randomized 1:1 to more-intensive (target SBP ≤120mmHg within 1 hour) or less-intensive (target SBP 140-180mmHg) BP management over 72 hours. Recruitment was suspended in June 2022 due to safety concerns in the more-intensive BP management group. More intensive BP lowering was shown to be associated with worse functional outcomes and more early neurological deterioration, compared to less intensive BP control. These data will have an impact on clinical practice, emphasizing that 120mmHg is the lower safety margin and BP lowering efforts should not go beyond this. While these findings have narrowed the goal window, questions remain on the optimal target for BP lowering. This interview took place at the World Stroke Congress 2022 in Singapore. These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.