Abstract WMP87: Effect Of Intensive Blood Pressure Treatment After Successful Reperfusion On Outcome According To End Of Procedure Blood Pressure: Insight From The Bp Target Trial

Abstract

Backgroup: The Safety and efficacy of intensive blood pressure lowering after successful endovascular therapy in acute ischaemic stroke (BP TARGET) trial demonstrated no benefit of systolic blood pressure (SBP) intensive lowering treatment after successful reperfusion. However, it is still unknown whether end of procedure SBP modifies the treatment effect of SBP intensive lowering treatment after successful reperfusion. Methods: This is a post hoc analysis of the BP TARGET multicenter trial. Patients were enrolled in the BP TARGET trial if they achieved successful reperfusion with EVT and had systolic blood pressure (SBP) ≥130 mmHg at the end of procedure. Patients were randomized in 1:1 fashion to intensive SBP treatment (SBP target 100-129 mmHg to be achieved within 1 hour of randomization) or standard SBP treatment (SBP target 130-185 mmHg). In this study, patients were divided into two groups based on end of procedure SBP (<160 mmHg, ≥ 160 mmHg). Primary outcome was any intracerebral hemorrhage and secondary outcome was favorable outcome ( modified Rankin Scale 0-2 ) at 90 days. Results: A total of 290 patients were included in the present study (141 patients in the intensive treatment arm and 149 patients in the standard arm). A total of 105 patients had end of procedure SBP≥160 mmHg (53 in the intensive arm and 52 in the standard arm) and 185 patients had SBP<160mmHg (88 in the intensive arm and 97 in the standard arm). Intensive SBP treatment was not associated with any intracerebral hemorrhage or favorable outcome in both <160 mmHg and ≥160mmHg groups (Table 1). Moreover, there was no heterogeneity of treatment effect according to end of procedure SBP. Conclusion: End of procedure SBP did not modify the treatment effect of SBP lowering treatment after successful reperfusion.