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ATACH-2

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https://www.readbyqxmd.com/read/29789395/blood-pressure-attained-analysis-of-atach-2-trial
#1
Adnan I Qureshi, Yuko Y Palesch, Lydia D Foster, William G Barsan, Joshua N Goldstein, Daniel F Hanley, Chung Y Hsu, Claudia S Moy, Mushtaq H Qureshi, Robert Silbergleit, Jose I Suarez, Kazunori Toyoda, Haruko Yamamoto
BACKGROUND AND PURPOSE: We compared the rates of death or disability, defined by modified Rankin Scale score of 4 to 6, at 3 months in patients with intracerebral hemorrhage according to post-treatment systolic blood pressure (SBP)-attained status. METHODS: We divided 1000 subjects with SBP ≥180 mm Hg who were randomized within 4.5 hours of symptom onset as follows: SBP <140 mm Hg achieved or not achieved within 2 hours; subjects in whom SBP <140 mm Hg was achieved within 2 hours were further divided: SBP <140 mm Hg for 21 to 22 hours (reduced and maintained) or SBP was ≥140 mm Hg for at least 2 hours during the period between 2 and 24 hours (reduced but not maintained)...
June 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29710119/cerebral-microbleeds-and-the-effect-of-intensive-blood-pressure-reduction-on-hematoma-expansion-and-functional-outcomes-a-secondary-analysis-of-the-atach-2-randomized-clinical-trial
#2
Ashkan Shoamanesh, Andrea Morotti, Javier M Romero, Jamary Oliveira-Filho, Frieder Schlunk, Michael J Jessel, Alison M Ayres, Anastasia Vashkevich, Kristin Schwab, Mohammad R Afzal, Christy Cassarly, Renee H Martin, Adnan I Qureshi, Steven M Greenberg, Jonathan Rosand, Joshua N Goldstein
Importance: Response to intensive blood pressure (BP) lowering in acute intracerebral hemorrhage (ICH) might vary with the degree of underlying cerebral small vessel disease. Objectives: To characterize cerebral microbleeds (CMBs) in acute ICH and to assess the potential for interaction between underlying small vessel disease (as indicated by CMB number and location) and assignment to acute intensive BP targeting for functional outcomes and hematoma expansion. Design, Setting, and Participants: Preplanned subgroup analyses in the Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 (ATACH-2) trial were performed...
April 16, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/28004328/management-of-acute-hypertensive-response-in-intracerebral-hemorrhage-patients-after-atach-2-trial
#3
Shahram Majidi, Jose I Suarez, Adnan I Qureshi
Acute hypertensive response is elevation of systolic blood pressure (SBP) in the first 24 h after symptom onset which is highly prevalent in patients with intracerebral hemorrhage (ICH). Observational studies suggested association between acute hypertensive response and hematoma expansion, peri-hematoma edema and death and disability, and possible reduction in these adverse outcomes with treatment of acute hypertensive response. Recent clinical trials have focused on determining the clinical efficacy of early intensive SBP reduction in ICH patients...
October 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27276234/intensive-blood-pressure-lowering-in-patients-with-acute-cerebral-hemorrhage
#4
RANDOMIZED CONTROLLED TRIAL
Adnan I Qureshi, Yuko Y Palesch, William G Barsan, Daniel F Hanley, Chung Y Hsu, Renee L Martin, Claudia S Moy, Robert Silbergleit, Thorsten Steiner, Jose I Suarez, Kazunori Toyoda, Yongjun Wang, Haruko Yamamoto, Byung-Woo Yoon
BACKGROUND: Limited data are available to guide the choice of a target for the systolic blood-pressure level when treating acute hypertensive response in patients with intracerebral hemorrhage. METHODS: We randomly assigned eligible participants with intracerebral hemorrhage (volume, <60 cm(3)) and a Glasgow Coma Scale (GCS) score of 5 or more (on a scale from 3 to 15, with lower scores indicating worse condition) to a systolic blood-pressure target of 110 to 139 mm Hg (intensive treatment) or a target of 140 to 179 mm Hg (standard treatment) in order to test the superiority of intensive reduction of systolic blood pressure to standard reduction; intravenous nicardipine to lower blood pressure was administered within 4...
September 15, 2016: New England Journal of Medicine
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