Characteristics, management and response to alteplase in China versus non-China participants of the ENCHANTED trial

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dc.contributor.authorSong, Lily
dc.contributor.authorWang, Xia
dc.contributor.authorRobinson, Thompson
dc.contributor.authorLindley, Richard I
dc.contributor.authorArima, Hisatomi
dc.contributor.authorLavados, Pablo
dc.contributor.authorChen, Xiaoying
dc.contributor.authorChalmers, John
dc.contributor.authorAnderson, Craig S
dc.date.accessioned2022-01-18T16:17:46Z
dc.date.available2022-01-18T16:17:46Z
dc.date.issued2017
dc.description.abstractBackground: The characteristics of patients with acute ischaemic stroke (AIS) and their management vary across regions, which may influence outcomes. We examined for differential patterns of outcome between China and non-China participants of the ENhanced Control of Hypertension And Thrombolysis strokE stuDy (ENCHANTED), which tested different alteplase doses in AIS. Methods: ENCHANTED was an international, multicentre, open, blinded-endpoint trial of the effects of low-dose (0.6 mg/kg) versus standard-dose (0.9 mg/kg) intravenous alteplase on 90-day disability outcomes and symptomatic intracerebral haemorrhage (sICH) in 3310 patients with AIS. Results: Participants (n=1419, 48%) in China were younger, and more often male, hypertensive and with prior stroke and coronary artery disease, but less likely to have atrial fibrillation and use antihypertensive, antithrombotic and lipid-lowering agents, compared with non-China patients with AIS. Although China participants had more AIS due to large artery occlusion, were treated later and had differing ancillary management, there was no significant difference in 90-day modified Rankin scale scores 2-6 (55.6% vs 47.8%; OR, adjusted for baseline and management factors 0.87 (95% CI 0.71 to 1.07; p=0.20)) and risk of sICH (Safe Implementation of Thrombolysis in Stroke-Monitoring Study criteria: 1.4% vs 1.8%; p=0.12) compared with non-China participants. There was no heterogeneity in the treatment effects of low-dose versus standard-dose alteplase between China and non-China participants. Conclusion: Patients with AIS recruited to the ENCHANTED trial in China had similar outcomes in response to thrombolysis treatment despite significantly differing demographic, clinical and management factors to patients with AIS in other regions.es
dc.identifier.citationSong L, Wang X, Robinson T, Lindley RI, Arima H, Lavados PM, Chen X, Chalmers J, Anderson CS. Characteristics, management and response to alteplase in China versus non-China participants of the ENCHANTED trial. Stroke Vasc Neurol. 2017 May 22;2(2):53-58.es
dc.identifier.urihttp://dx.doi.org/10.1136/svn-2017-000085es
dc.identifier.urihttp://hdl.handle.net/11447/5475
dc.language.isoen_USes
dc.subjectAcute ischemic strokees
dc.subjectClinical triales
dc.subjectIntravenous thrombolysises
dc.titleCharacteristics, management and response to alteplase in China versus non-China participants of the ENCHANTED triales
dc.typeArticlees

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