Journal article

Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial

Craig S Anderson, Yining Huang, Richard I Lindley, Xiaoying Chen, Hisatomi Arima, Guofang Chen, Qiang Li, Laurent Billot, Candice Delcourt, Philip M Bath, Joseph P Broderick, Andrew M Demchuk, Geoffrey A Donnan, Alice C Durham, Pablo M Lavados, Tsong-Hai Lee, Christopher Levi, Sheila O Martins, Veronica V Olavarria, Jeyaraj D Pandian Show all

LANCET | ELSEVIER SCIENCE INC | Published : 2019

Abstract

BACKGROUND: Systolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intravenous alteplase in patients with acute ischaemic stroke, but the target systolic blood pressure for optimal outcome is uncertain. We assessed intensive blood pressure lowering compared with guideline-recommended blood pressure lowering in patients treated with alteplase for acute ischaemic stroke. METHODS: We did an international, partial-factorial, open-label, blinded-endpoint trial of thrombolysis-eligible patients (age ≥18 years) with acute ischaemic stroke and systolic blood pressure 150 mm Hg or more, who were screened at 110 sites in 15 countries. Eligible patients were..

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Grants

Awarded by National Health and Medical Research Council (NHMRC) of Australia


Awarded by UK Stroke Association


Awarded by Ministry of Health and the National Council for Scientific and Technological Development of Brazil


Awarded by Ministry for Health, Welfare, and Family Affairs of South Korea


Funding Acknowledgements

National Health and Medical Research Council of Australia; UK Stroke Association; Ministry of Health and the National Council for Scientific and Technological Development of Brazil; Ministry for Health, Welfare, and Family Affairs of South Korea; Takeda.The study is supported by grants from the National Health and Medical Research Council (NHMRC) of Australia (project grant numbers 1020462 and 1101113); the UK Stroke Association (TSA 2012/01 and 2015/01); the Ministry of Health and the National Council for Scientific and Technological Development of Brazil (CNPQ 467322/2014-7 and 402388/2013-5); the Ministry for Health, Welfare, and Family Affairs of South Korea (HI14C1985; for the alteplase-dose arm); and a research grant from Takeda for conduct of the study in China. The research team acknowledges the support of the National Institute for Health Research (NIHR) Clinical Research Network for conduct of the trial in the UK, and the EuroQol Group for use of the EQ-5D-3L. CSA is a Senior Principal Research Fellow for the NHMRC. TGR and PMB are NIHR Senior Investigators. PMB is the Professor of Stroke Medicine for the Stroke Association. We thank the investigators and research staff at the participating sites (appendix), members of the trial steering and data and safety monitoring board committees (appendix), and executive staff of The George institute for Global Health for their support of the study. We also thank the participants, and their families and friends.