Low-Dose vs Standard-Dose Alteplase in Acute Lacunar Ischemic Stroke The ENCHANTED Trial

Zien Zhou; Candice Delcourt; Chao Xia; Sohei Yoshimura; Cheryl Carcel; Takako Torii-Yoshimura; Shoujiang You; Alejandra Malavera; Xiaoying Chen; Maree L Hackett; Mark Woodward; John Chalmers; Jianrong Xu; Thompson G Robinson; Mark W Parsons; Andrew M Demchuk; Richard Lindley; Grant Mair; Joanna M Wardlaw; Craig S Anderson

Journal article

Low-Dose vs Standard-Dose Alteplase in Acute Lacunar Ischemic Stroke The ENCHANTED Trial

Zien Zhou, Candice Delcourt, Chao Xia, Sohei Yoshimura, Cheryl Carcel, Takako Torii-Yoshimura, Shoujiang You, Alejandra Malavera, Xiaoying Chen, Maree L Hackett, Mark Woodward, John Chalmers, Jianrong Xu, Thompson G Robinson, Mark W Parsons, Andrew M Demchuk, Richard Lindley, Grant Mair, Joanna M Wardlaw, Craig S Anderson

NEUROLOGY | LIPPINCOTT WILLIAMS & WILKINS | Published : 2021

DOI: 10.1212/WNL.0000000000011598

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Abstract

OBJECTIVE: To determine any differential efficacy and safety of low- vs standard-dose IV alteplase for lacunar vs nonlacunar acute ischemic stroke (AIS), we performed post hoc analyzes from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) alteplase dose arm. METHODS: In a cohort of 3,297 ENCHANTED participants, we identified those with lacunar or nonlacunar AIS with different levels of confidence (definite/according to prespecified definitions based on clinical and adjudicated imaging findings. Logistic regression models were used to determine associations of lacunar AIS with 90-day outcomes (primary, modified Rankin Scale [mRS] scores 2-6; secondary, other mRS ..

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University of Melbourne Researchers

Mark Parsons Author Medicine - Royal Melbourne Hospital

Grants

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

Awarded by Stroke Association of the UK

Awarded by National Council for Scientific and Technological Development of Brazil (CNPQ)

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

Funding Acknowledgements

This study is supported by grants from the National Health and Medical Research Council (NHMRC) of Australia (project grant numbers 1020462 and 1101113), the Stroke Association of the UK (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, 402388/2013-5), the Ministry for Health, Welfare and Family Affairs of the Republic of Korea (HI14C1985) (for the alteplase-dose arm), and a research grant from Takeda for conduct of the study in China.