The George Institute for Global Health
Neurology
Craig Anderson is Professor of Neurology and Epidemiology, University of New South Wales, Sydney, Australia and Director of Global Brain Health initiative at The George Institute for Global Health. He is a neurologist at Royal Prince Alfred Hospital, Australia, and holds a Senior Leadership Fellowship of the National Health and Medical Research Council of Australia. Craig is an international authority on the causes, treatment and management of stroke, and other aspects of cardiovascular disease, who leads international clinical trials and population research in 20+ countries. He has developed national clinical guidelines, provides leadership to a range of research groups and professorial societies including as President of the Asia Pacific Stroke Organisation and Stroke Society of Australasia. He is Editor-in-Chief of the journal, Cerebrovascular Diseases, and Associate Editor of the International Journal of Stroke.

Moderator of 2 Sessions

Session Type
Acute Stroke Treatment
Date
Wed, 26.10.2022
Session Time
08:00 - 09:30
Room
Hall 406
Session Type
Clinical Manifestations
Date
Thu, 27.10.2022
Session Time
08:00 - 09:30
Room
Room 331

Presenter of 5 Presentations

Opening by Chairs

Session Type
Acute Stroke Treatment
Date
Wed, 26.10.2022
Session Time
08:00 - 09:30
Room
Hall 406
Lecture Time
08:00 - 08:02

Latest Data on Blood Pressure Management in ICH

Session Type
Acute Stroke Treatment
Date
Wed, 26.10.2022
Session Time
15:30 - 17:00
Room
Hall 406
Lecture Time
15:46 - 16:00

Closing by Chairs

Session Type
Acute Stroke Treatment
Date
Wed, 26.10.2022
Session Time
08:00 - 09:30
Room
Hall 406
Lecture Time
09:25 - 09:30

Blood Pressure Management in Acute Stroke

Session Type
Acute Stroke Treatment
Date
Wed, 26.10.2022
Session Time
08:00 - 09:30
Room
Hall 406
Lecture Time
08:19 - 08:36

THE SECOND ENHANCED CONTROL OF HYPERTENSION AND THROMBECTOMY STROKE STUDY (ENCHANTED2) RANDOMIZED CONTROLLED TRIAL RESULTS

Session Type
Plenary Session
Date
Fri, 28.10.2022
Session Time
13:30 - 15:00
Room
Hall 406
Lecture Time
14:07 - 14:17

Abstract

Background and Aims

We aimed to resolve uncertainty and determine the effectiveness and safety of blood pressure (BP) lowering after mechanical thrombectomy (MT) for acute ischemic stroke (AIS).

Methods

ENCHANTED2 (clinicaltrials.gov NCT04140110) was an investigator-initiated, multicenter, prospective, randomized, open, blinded-endpoint trial of intensive systolic BP (SBP) control in reperfused (extended thrombolysis in cerebral infarction classification 2b/2c/3) for any large-vessel occlusion (LVO)-AIS patients with persistent hypertension (SBP ≥140mmHg) at 45 hospitals in China. Eligible patients were centrally randomly allocated to more-intensive (target SBP ≤120mmHg within 1 hour) or less-intensive (target SBP 140-180mmHg) BP management over 72 hours. A sample size of 2257 patients was estimated to provide 90% power to detect a 6.48% absolute reduction in the primary outcome, a shift in modified Rankin scale scores at 90 days, from more-intensive BP lowering, using ordinal logistic regression.

Results

Recruitment started in July 2020. At a meeting of the Data Safety Monitoring Board in March 2022 to review primary outcome available for 347 patients, they recommended suspension of recruitment due to safety concerns in the more-intensive group; which was implemented by the Trial Steering Committee (TSC), with 817 randomized patients and mean SBP 125mmHg and 143mmHg at 1 hour (mean difference -18mmHg) in the more-intensive and less-intensive groups, respectively. As safety concerns persisted on further review of the data in June 2022, the TSC stopped recruitment to allow unblinding and presentation of the results.

Conclusions

ENCHANTED2 will provide key randomized evidence on the role of intensive BP lowering after reperfusion in MT-treated AIS patients.

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