https://nova.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:14864 Wed 11 Apr 2018 10:29:15 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:29402 Wed 11 Apr 2018 10:13:01 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:24519 Wed 09 Mar 2022 16:03:44 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:51192 150 mm Hg) after thrombolysis treatment for acute ischaemic stroke between March 3, 2012 and April 30, 2018. Methods: All available brain imaging were analysed centrally by expert readers. Log-linear regression was used to determine the effects of intensive blood pressure lowering on the size of cerebral infarction, with adjustment for potential confounders. The primary analysis pertained to follow-up computerised tomography (CT) scans done between 24 and 36 h. Sensitivity analysis were undertaken in patients with only a follow-up magnetic resonance imaging (MRI) and either MRI or CT at 24–36 h, and in patients with any brain imaging done at any time during follow-up. This trial is registered with ClinicalTrials.gov, number NCT01422616. Findings: There were 1477 (67.3%) patients (mean age 67.7 [12.1] y; male 60%, Asian 65%) with available follow-up brain imaging for analysis, including 635 patients with a CT done at 24–36 h. Mean achieved systolic blood pressures over 1–24 h were 141 mm Hg and 149 mm Hg in the intensive group and guideline group, respectively. There was no effect of intensive blood pressure lowering on the median size (ml) of cerebral infarction on follow-up CT at 24–36 h (0.3 [IQR 0.0–16.6] in the intensive group and 0.9 [0.0–12.5] in the guideline group; log Δmean −0.17, 95% CI −0.78 to 0.43). The results were consistent in sensitivity and subgroup analyses. Interpretation: Intensive blood pressure lowering treatment to a systolic target <140 mm Hg within several hours after the onset of symptoms may not increase the size of cerebral infarction in patients who receive thrombolysis treatment for acute ischaemic stroke of mild to moderate neurological severity. Funding: National Health and Medical Research Council of Australia; UK Stroke Association; UK Dementia Research Institute; Ministry of Health and the National Council for Scientific and Technological Development of Brazil; Ministry for Health, Welfare, and Family Affairs of South Korea; Takeda.]]> Thu 24 Aug 2023 14:38:31 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27846 90, 60-90, and <60 mL/min/1.73 m², respectively). Outcomes: The effect of admission eGFR on the primary outcome of death or major disability at 90 days (defined as modified Rankin Scale scores of 3-6) was analyzed using a multivariable logistic regression model. Potential effect modification of intensive BP lowering treatment by admission eGFR was assessed by interaction terms. Results: Of 2,623 included participants, 912 (35%) and 280 (11%) had mildly and moderately/severely decreased eGFRs, respectively. Patients with moderately/severely decreased eGFRs had the greatest risk for death or major disability at 90 days (adjusted OR, 1.82; 95% CI, 1.28-2.61). Effects of early intensive BP lowering were consistent across different eGFRs (P = 0.5 for homogeneity). Limitations: Generalizability issues arising from a clinical trial population. Conclusions: Decreased eGFR predicts poor outcome in acute ICH. Early intensive BP lowering provides similar treatment effects in patients with ICH with decreased eGFRs.]]> Thu 09 Dec 2021 11:03:39 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10744 Sat 24 Mar 2018 08:08:21 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10748 Sat 24 Mar 2018 08:08:19 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:17347 Sat 24 Mar 2018 08:01:42 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27845 Sat 24 Mar 2018 07:41:17 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27092 Sat 24 Mar 2018 07:40:35 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:4851 Sat 24 Mar 2018 07:18:46 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:22862 Sat 24 Mar 2018 07:16:01 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:46642 p < 0.0001). There was no heterogeneity of the effects of BP lowering (intensive vs. guideline) on functional recovery between standard-dose (OR 0.81, 95% CI 0.59-1.12) and low-dose alteplase (1.06, 0.77-1.47; p = 0.25 for interaction). Similar results were observed for ICH (p = 0.50 for interaction). Conclusions: In thrombolysis-treated patients with predominantly mild-to-moderate severity AIS, intensive BP lowering neither improve functional recovery, either with low-or standard-dose intravenous alteplase, nor beneficially interact with low-dose alteplase in reducing ICH. Trial Registration: The trial is registered with ClinicalTrials.gov (NCT01422616).]]> Mon 28 Nov 2022 16:54:24 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:30005 Mon 17 Oct 2022 12:06:14 AEDT ]]>