Abstract:
BACKGROUND AND RATIONALE:Uncertainty persists over the optimal management of blood pressure (BP) in the early phase of acute ischemic stroke (AIS). This study aims to determine the safety and effects of intensive BP lowering on cerebral blood flow (CBF) and functional in AIS patients treated with intravenous thrombolysis. METHODS:In a randomized controlled trial, 54 thrombolysed AIS patients with a systolic BP of 160 to 180 mm Hg will be randomized to early intensive BP lowering (systolic target range 140-160 mm Hg) or guideline-based BP management (systolic range 160-180 mm Hg) during first 72-hours using primarily intravenous labetalol. We hypothesize that early intensive BP lowering will not reduce CBF by 20% and/or increase the volume of hypoperfused tissue by >20% on computed tomographic perfusion. Clinical outcome will be assessed using a dichotomized modified Rankin scale (scores 0-1 as excellent outcome vs scores 2-6 as dead or dependent) at 90 days. Other outcome would be symptomatic intracerebral hemorrhage. The trial is registered at ClinicalTrials.gov, NCT03443596. CONCLUSION:This randomized study will provide important information about the physiological effects of BP reduction on cerebral perfusion after intravenous thrombolysis in AIS.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Sharma VK,Tan BYQ,Sim MY,Kulkarni A,Seow PA,Hong CS,Du Z,Wong LYH,Chen J,Chee EYH,Ng BSM,Low Y,Ngiam NJH,Yeo LLL,Teoh HL,Paliwal PR,Rathakrishnan R,Sinha AK,Chan BPL,Butcher K,Anderson CSdoi
10.1097/MD.0000000000012721subject
Has Abstractpub_date
2018-10-01 00:00:00pages
e12721issue
40eissn
0025-7974issn
1536-5964pii
00005792-201810050-00094journal_volume
97pub_type
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