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  • 1
    Online Resource
    Online Resource
    Early Blood Pressure Lowering Does Not Reduce Growth of Intraventricular Hemorrhage following Acute Intracerebral Hemorrhage: Results of the INTERACT Studies
    S. Karger AG ; 2016
    In:  Cerebrovascular Diseases Extra Vol. 6, No. 3 ( 2016-9-8), p. 71-75
    Details
    In: Cerebrovascular Diseases Extra, S. Karger AG, Vol. 6, No. 3 ( 2016-9-8), p. 71-75
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Intraventricular hemorrhage (IVH) extension is common following acute intracerebral hemorrhage (ICH) and is associated with poor prognosis. 〈 b 〉 〈 i 〉 Aim: 〈 /i 〉 〈 /b 〉 To determine whether intensive blood pressure (BP)-lowering therapy reduces IVH growth. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Pooled analyses of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT1 and INTERACT2) computed tomography (CT) substudies; multicenter, open, controlled, randomized trials of patients with acute spontaneous ICH and elevated systolic BP, randomly assigned to intensive ( 〈 140 mm Hg) or guideline-based ( 〈 180 mm Hg) BP management. Participants had blinded central analyses of baseline and 24-hour CT. Association of BP lowering to IVH growth was assessed in analysis of covariance. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 There was no significant difference in adjusted mean IVH growth following intensive (n = 228) compared to guideline-recommended (n = 228) BP treatment (1.6 versus 2.2 ml, respectively; p = 0.56). Adjusted mean IVH growth was nonsignificantly greater in patients with a mean achieved systolic BP ≥160 mm Hg over 24 h (3.94 ml; p trend = 0.26). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Early intensive BP-lowering treatment had no clear effect on IVH in acute ICH.
    Type of Medium: Online Resource
    ISSN: 1664-5456
    URL: Article
    DOI: 10.1159/000448897
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 2651613-5
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  • 2
    Online Resource
    Online Resource
    Determinants and Prognostic Significance of Hematoma Sedimentation Levels in Acute Intracerebral Hemorrhage
    S. Karger AG ; 2016
    In:  Cerebrovascular Diseases Vol. 41, No. 1-2 ( 2016), p. 80-86
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 41, No. 1-2 ( 2016), p. 80-86
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 This study aimed at identifying the determinants and prognostic significance of a sedimentation level (fluid-blood level) in the hematoma among patients with acute intracerebral hemorrhage (ICH) who participated in the main Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Post-hoc analysis of the INTERACT2 dataset, a randomized controlled trial of patients with acute ICH with elevated systolic blood pressure (SBP), randomly assigned to intensive (target SBP 〈 140 mm Hg) or guideline-based ( 〈 180 mm Hg) BP management. Patients with a sedimentation level at baseline assessment on CT, and modified Rankin Scale score at 90-day, were included in these analyses. Factors associated with a sedimentation level and its significance in relation to 90-day clinical outcomes were assessed in univariable and multivariable logistic regression models. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 2,065 participants, 19 (1%) had sedimentation level on baseline CT, which was independently associated with warfarin use (p = 0.006) and lobar ICH (p = 0.025). Sedimentation level was also associated with death or major disability at 90-day in both crude (84 vs. 53%; p = 0.014) and multivariable analyses adjusted for age, gender, Chinese region, warfarin use, baseline National Institutes of Health Stroke Scale score, onset to CT time, volume and location of ICH, intraventricular extension, and randomized intensive BP lowering (OR 3.94, 95% CI 1.01-15.37; p = 0.049). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The presence of hematoma sedimentation level on baseline CT is associated with warfarin use and lobar location of ICH, and predicts a worse outcome. Although uncommon, sedimentation level is an easily detectable prognostic factor in acute ICH.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000442532
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 1482069-9
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  • 3
    Online Resource
    Online Resource
    Off-Hour Admission and Outcomes in Patients with Acute Intracerebral Hemorrhage in the INTERACT2 Trial
    S. Karger AG ; 2015
    In:  Cerebrovascular Diseases Vol. 40, No. 3-4 ( 2015), p. 114-120
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 40, No. 3-4 ( 2015), p. 114-120
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Conflicting data exist of an association between off-hour (weekend, holiday, or night-time) hospital admission and adverse outcome in intracerebral hemorrhage (ICH). We determined the association between off-hour admissions and poor clinical outcome, and of any differential effect of early intensive blood pressure (BP) lowering treatment between off- and on-hour admissions, among participants of the Intensive BP Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Subsidiary analysis of INTERACT2, a multinational, multicenter, clinical trial of patients with spontaneous ICH with elevated systolic BP, randomly assigned to intensive (target systolic BP 〈 140 mm Hg) or guideline-based ( 〈 180 mm Hg) BP management. Primary outcome was death or major disability (modified Rankin scale of 3-6) at 90 days. Off-hour admission was defined as night-time (4:30 p.m. to 8:30 a.m.) on weekdays, weekends (Saturday and Sunday), and public holidays in each participating country. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 2,794 patients with information on the primary outcome, 1,770 (63%) were admitted to study centers during off-hours. Off-hour admission was not associated with risk of poor outcome at 90 days (53% off-hour vs. 55% on-hour; p = 0.49), even after adjustment for comorbid risk factors (odds ratio 0.92; 95% CI 0.76-1.12). Consistency exists in the effects of intensive BP lowering between off- and on-hour admission (p = 0.85 for homogeneity). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Off-hour admission was not associated with increased risks of death or major disability among trial protocol participants with acute ICH. Intensive BP lowering can provide similar treatment effect irrespective of admission hours.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000434690
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1482069-9
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