Mikael Mazighi 1 , 2 , 3 , 4 , * , Julien Labreuche 5 , Sebastien Richard 6 , 7 , Benjamin Gory 8 , 9 , Bertrand Lapergue 10 , Igor Sibon 11 , Jerome Berge 12 , Jean-Marc Olivot 13 , Peggy Reiner 14 , Emmanuel Houdart 15 , Joseph Broderick 16 , Alain Duhammel 5 , Benjamin Maier 1 , Amélie Yavchitz 17 , Laurence Salomon 17 , Michael Obadia 18 , Raphael Blanc 1 , 2 , Julien Savatovsky 19 , Michel Piotin 1 , 2
19 June 2020
Background: High systolic blood pressure (BP) is associated with an increased risk of intracranial hemorrhage (ICH) in patients undergoing reperfusion therapy. However, there are no data from randomized trials to guide BP management after reperfusion following endovascular therapy (EVT) for patients with acute ischemic stroke (AIS) with large vessel occlusion (LVO). The objective is to evaluate if BP control with a target of 100–129 mmHg systolic BP (“tight” SBP control) can reduce ICH as compared to 130–185 mmHg (“usual” SBP control) in AIS participants after reperfusion by EVT.
Methods: The BP TARGET trial is a multicenter, prospective, randomized, controlled, open-label, blinded endpoint clinical trial. AIS participants with LVO experiencing successful reperfusion are randomly assigned, in a 1:1 ratio, to have a “tight” SBP control (100–129 mmHg) or a conservative SBP control (130–185 mmHg) during the following 24–36 h. The primary outcome is the rate of ICH (either symptomatic or asymptomatic) on follow-up CT scan at 24–36 h. Secondary outcomes include the rate of the symptomatic ICH, the overall distribution of the modified Rankin Scale (mRS) at 90 days, favorable outcome (90–day mRs 0–2), infarct volume at follow-up CT scan at 24–36 h, change in National Institute of Health Stroke Scale at 24 h, and all-cause mortality at 90 days.
Conclusion: This is the first randomized trial directly comparing the efficacy of different SBP targets after EVT reperfusion. This prospective trial aims to determine whether a “tight” SBP control after EVT reperfusion can reduce the risk of ICH.