Interaction of brain imaging features and effects of intensive blood pressure lowering after endovascular treatment for acute ischaemic stroke: the pre-specified secondary analyses of ENCHANTED2/MT trial

作者：Xiaoxi Zhang, Xinwen Ren, Yongxin Zhang, Yongwei Zhang, Lei Zhang, Hongjian Shen, Zifu Li, Pengfei Xing, Ping Zhang, Weilong Hua, Fang Shen, Bing Tian, Wenhuo Chen, Hongxing Han, Liyong Zhang, Chenghua Xu, Tong Li, Yu Gao, Yu Zhou, Qiao Zuo, Dongwei Dai, Rui Zhao, Qiang Li, Qinghai Huang, Yi Xu, Xiaoying Chen, Qiang Li, Lili Song, Craig S. Anderson, Pengfei Yang, Jianmin Liu · 发表于：EClinicalMedicine · 年份：2025 · DOI：10.1016/j.eclinm.2025.103197 · 被引用次数：7 · 研究领域：Acute Ischemic Stroke Management、Intracerebral and Subarachnoid Hemorrhage Research、S100 Proteins and Annexins

Summary Background The second Enhanced Control of Hypertension and Thrombectomy Stroke Study (ENCHANTED2/MT) was terminated early when the intensive blood pressure lowering to a systolic level of 120 mm Hg or lower, compared to 140–180 mm Hg, was harmful in patients who received successful endovascular therapy for acute ischaemic stroke due to large-vessel occlusion. We aimed to determine the interaction of key brain imaging features and the effect of treatment on clinical outcomes. Methods ENCHANTED2/MT was a prospective, randomised, open-label, blinded-endpoint, controlled trial that aimed to assess the effectiveness of different intensities of blood pressure control on the functional independence in patients who had received successful endovascular therapy for acute ischaemic stroke from large-vessel occlusion at 44 hospitals in China between July 20, 2020 and March 7, 2022. In these pre-specified secondary analyses, neuroradiologists reviewed the baseline brain images of participants (computerised tomography [CT], CT with angiography [CTA] and digital subtraction angiography [DSA]) blind to treatment allocation, to determine the degree of cerebral infarction on the Alberta Stroke Program Early CT Score (ASPECTS), collateral status according to modified TAN score, and degree of reperfusion on the expanded Treatment In Cerebral Infarction (eTICI) scale. The primary outcome was functional independence, according to the distribution of scores on the modified Rankin scale ...