Neuroanesthesia & neurocritical care
Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke: The OPTIMAL-BP Randomized Clinical Trial
- terminated early
- Terminated early on the recommendation of the data and safety monitoring board, which noted safety concerns
Authors' conclusion
Among patients who achieved successful reperfusion with EVT for acute ischemic stroke with large vessel occlusion, intensive BP management for 24 hours led to a lower likelihood of functional independence at 3 months compared with conventional BP management.
Study context
- Population
- Patients with large vessel occlusion acute ischemic stroke treated with endovascular thrombectomy (EVT) with modified Thrombolysis in Cerebral Infarction score ≥2b, 19 stroke centers in South Korea, 2020–2022302 completed
- Participants
- 306 patients
- Comparison
- Intensive vs Conventional
- Intensiven = 155
- Conventionaln = 150reference
- Primary endpoint
- Functional independence (modified Rankin Scale score 0-2)
- Follow-up
- 3 months
Methodological detailsmulticentre, open-label, blinded end-point evaluation
- Multicentre
- Open-label
- Blinded end-point evaluation
Primary result
As reported in the abstract
Functional independence (mRS 0-2)
Each group vs conventionalRisk difference (95% CI)
Intensive
−15.1%(−26.2% to −3.9%)
Each group vs conventionalAdjusted odds ratio (95% CI)P value
Intensive
0.56(0.33–0.96)
P = 0.03Further findings
| Outcome | Intensive | Conventional | Risk difference (95% CI) | |
|---|---|---|---|---|
| Death related to the index stroke · within 3 months | 7.7% | 5.4% | 2.3% (−3.3% to 7.9%) | |
| −50510Difference (linear scale) |
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Death related to the index stroke · within 3 months | 1.73 (0.61–4.92) | P = 0.31 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Safety
| Outcome | Intensive | Conventional | Risk difference (95% CI) | |
|---|---|---|---|---|
| Symptomatic intracerebral hemorrhage · within 36 hours | 9.0% | 8.1% | 1.0% (−5.3% to 7.3%) | |
| −10−50510Difference (linear scale) |
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Symptomatic intracerebral hemorrhage · within 36 hours | 1.10 (0.48–2.53) | P = 0.82 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Original publication
Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke: The OPTIMAL-BP Randomized Clinical Trial. JAMA. Published 5 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →