Early intensive blood pressure management after endovascular treatment in ischaemic stroke (IDENTIFY): a multicentre, open-label, blinded-endpoint, randomised controlled trial

作者：Xuening Zhang, Le Cao, Simiao Wu, Duolao Wang, Hang Wang, Dingwen Zhang, Jian Wang, Lizhang Chen, Xue Lin, Decai Qian, Qin-Jun Zhang, Lan Xiong, Weiping Wang, Yufeng Tang, Bo Lei, Tianzhu Liu, Jie He, Li Ping Wang, Fuqiang Guo, Guangzong Li, Kuiyun Wang, Jinglun Li, Jun Luo, Jian Shen, Mangmang Xu, Hongbo Zheng, Dong Zhou, Ming Liu, Fayun Hu, Fayun Hu, Bo Wu, Bo Wu, Bo Wu, Bo Wu, Fayun Hu, Fayun Hu, Hongbo Zheng, Yufeng Tang, Decai Qian, Xiang Luo, Wenjie Zi, Xin Hu, Qingwu Yang, Weihai Xu, Anxin Wang, Duolao Wang, Le Cao, Dingwen Zhang, Xing Zhao, Bo Chen, Fayun Hu, Fayun Hu, Dong Zhou, Ming Liu, Hongbo Zheng, Xuening Zhang, Hang Wang, Mangmang Xu, Ping Wang, Zilong Hao, Jian Wang, Lizhang Chen, Xue Lin, Yuying Yan, Shuai Jiang, Chen Ye, Ruosu Pan, Tang Yang, Kun Lu, Wenzuo Shang, Jingyu Cui, Xueling Bai, Luyao Zhong, Yajun Cheng, Tianxiang Lan, Yuting Wu, Lanhua Liao, Xinyan Peng, Zengju Wue, Fayun Hu, Fayun Hu, Shuai Jiang, Chen Ye, Ruosu Pan, Tang Yang, Yuying Yan, Yuting Wu, Hang Wang, Ping Wang, Luyao Zhong, Yajun Cheng, Youjie Wang, Congjun Li, Ruishan Liu, Yuan Yao, Jian Wang, Lizhang Chen, Xue Lin, Decai Qian, Lei Deng, Weiping Wang, Yong Yan, Lan Xiong, Chao Li, Qinjun Zhang, Wei Zhang, Yufeng Tang, Zhaokun Li, Bo Lei, Li Chen, Gaoxian Tianzhu Liu, Jie He, Li Wang, Yu Xie, Guangzong Li, Xiaojing Luo, Fuqiang Guo, Shu Yang, Jian Shen, Lei Zhang, Jun Luo, Zhenxuan Tian, Jinglun Li, Yuan Yang, Kuiyun Wang, Weigang Kong, Jie Shen, Xiangping Cheng, Huan Ren, Youlin Wu, Liu Hua, Hui Zheng, Dong Wei, Hong WangZ, Qingwei Yang, Yufeng Hou, Zhou Yu, Miao Peng, Haizhi Guo, Xiangrong Sun, Wei Fan, Zicheng Hu, Jun Liu, Bo Zhang, Yunbo Chen, Lei Liu, Long Zhou, Bo Li, Jiachuan Liao, Xin Zhou, Li Zhou, Xiaolin Tan, Jian Fan, Daqing Xu, Qin Liu, Jia Duan, Xiaojun Luo, Yuqi Peng, Chao He, Jiajun Huang, Jin Fan, Tiao Qiu, Xuanye Yue, Zhijin Yang, Zhuobo Zhang, Yifei Chen, Pingyun Zeng, Haowen Xu, Shenglin Deng, Xiaoyun She, Chunyu Lei, Yifei Ji · 发表于：The Lancet Regional Health - Western Pacific · 年份：2025 · DOI：10.1016/j.lanwpc.2025.101589 · 被引用次数：9 · 研究领域：Acute Ischemic Stroke Management、Intracerebral and Subarachnoid Hemorrhage Research、Neurological Disorders and Treatments

Background: The optimal blood pressure (BP) management following successful endovascular treatment (EVT) in acute ischaemic stroke (AIS) patients remains unclear. This study investigated the safety and efficacy of intensive BP control in AIS patients who had received EVT within 6 h. Methods: This randomised, multicentre, open-label, blinded-endpoint clinical trial (ChiCTR2200057770) was conducted at 63 stroke centres in China. Eligible participants had AIS due to large vessel occlusion in anterior circulation, underwent EVT within 6 h, and achieved successful recanalisation. Patients were randomised to intensive (systolic BP target <130 mm Hg) or standard (systolic BP target <180 mm Hg) management, maintained until 24 h post-EVT. The primary outcome was unfavourable functional outcome (modified Rankin Scale score of 3-6) at 90 days. The trial was terminated following a neutral interim analysis results and publication of counterpart randomised trials. Findings: Between October 14, 2022 and March 18, 2024, 383 patients were randomised. Unfavourable functional outcome occurred in 71.0% (130/183) of the intensive-management group and 67.5% (135/200) of the standard-management group (risk ratio, 1.05; 95% CI, 0.92-1.20; p = 0.45). There was no significant difference in symptomatic intracerebral haemorrhage, malignant brain oedema, or all-cause death at 90 days. Interpretation: Intensive BP management to <130 mm Hg did not improve outcomes in AIS patients undergoing EVT within 6 h ...