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Influence of renal function on blood pressure control and outcome in thrombolyzed patients after acute ischemic stroke: post-hoc analysis of the ENCHANTED trial

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dc.contributor.authorRen, Xinwen
dc.contributor.authorChen, Chen
dc.contributor.authorWang, Xia
dc.contributor.authorLi, Qiang
dc.contributor.authorZhao, Yang
dc.contributor.authorYou, Shoujiang
dc.contributor.authorOuyang, Menglu
dc.contributor.authorRobinson, Thompson
dc.contributor.authorLindley, Richard
dc.contributor.authorArima, Hisatomi
dc.contributor.authorChen, Xiaoying
dc.contributor.authorChalmers, John
dc.contributor.authorAnderson, Craig
dc.date.accessioned2025-08-20T19:55:01Z
dc.date.available2025-08-20T19:55:01Z
dc.date.issued2024
dc.description.abstractBackground: The effect of renal impairment in patients who receive intravenous thrombolysis for acute ischemic stroke (AIS) is unclear. We aimed to determine the associations of renal impairment and clinical outcomes and any modification of the effect of intensive versus guideline-recommended blood pressure (BP) control in the BP arm of the International Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Methods: We conducted a post-hoc analysis of the ENCHANTED BP arm, which involved 2,196 thrombolyzed AIS patients. Logistic regression models were used to define the association between eGFR and clinical outcomes of death, death or major disability [modified Rankin scale (mRS) scores 3-6], and major disability (mRS 3-5) at 90 days. Results: Of the 2,151 patients with available baseline renal function data (mean age 66.9 years; 38% women), 993 (46.2%), 822 (38.2%), and 336 (15.6%) had normal (eGFR ≥ 90 mL/min/1.73 m2), mildly (60-89), and moderate-to-severely impaired (<60) renal function, respectively. Compared with patients with normal eGFR, mortality was higher in those with moderate-to-severe renal impairment (adjusted odds ratio 1.77, 95% confidence interval 1.05-2.99; p = 0.031 for trend). However, the difference in death or major disability (mRS 3-6) was not significant between groups. There was no heterogeneity in the effect of intensive versus guideline-recommended BP-lowering treatment on death by grades of renal function (p for interaction = 0.545). Discussion: The presence of moderate-to-severe renal impairment is associated with increased mortality in thrombolyzed patients with AIS. Renal function does not modify the effect of early intensive BP-lowering treatment on death in this patient group.
dc.description.versionVersión Publicada
dc.identifier.citationRen X, Chen C, Wang X, Li Q, Zhao Y, You S, Ouyang M, Robinson T, Lindley RI, Arima H, Chen X, Chalmers J, Anderson CS, Song L. Influence of renal function on blood pressure control and outcome in thrombolyzed patients after acute ischemic stroke: post-hoc analysis of the ENCHANTED trial. Front Endocrinol (Lausanne). 2024 Dec 9;15:1341902. doi: 10.3389/fendo.2024.1341902
dc.identifier.doihttps://doi.org/10.3389/fendo.2024.1341902
dc.identifier.urihttps://hdl.handle.net/11447/10200
dc.language.isoen
dc.subjectAcute ischemic stroke
dc.subjectBlood pressure
dc.subjectClinical outcome
dc.subjectRenal function
dc.subjectThrombolysis
dc.titleInfluence of renal function on blood pressure control and outcome in thrombolyzed patients after acute ischemic stroke: post-hoc analysis of the ENCHANTED trial
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceFront Endocrinol (Lausanne)
dspace.entity.typePublication

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