Thrombolysis in Early Acute Ischemic Stroke Trial-Blood Pressure Management (EAST-BP)
Thrombolysis in Early Acute Ischemic Stroke Trial-Blood Pressure Management, EAST-BP
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Gang Li
- Phone Number: +86 021-38804518
- Email: ligang@tongji.edu.cn
Study Locations
-
-
-
Shanghai, China
- Recruiting
- Shanghai East Hospital
-
Contact:
- Gang Li
- Phone Number: +86 021-38804518
- Email: ligang@tongji.edu.cn
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 to 80 years (inclusive);
- Patients with acute ischemic stroke;
- Planned to receive intravenous thrombolysis within 4.5 hours of onset;
- Elevated blood pressure: Before receiving intravenous thrombolysis treatment, blood pressure is elevated: systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 100 mmHg (defined as two consecutive measurements within 2 minutes);
- Informed consent signed (or signed by a proxy).
Exclusion Criteria:
- Intracranial hemorrhage is indicated on CT or MRI (including parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural or epidural hematoma).
- History of intracranial hemorrhage; severe head trauma or stroke within the last 3 months.
- Intracranial tumors, giant intracranial aneurysms.
- Intracranial or spinal surgery within the last 3 months; major surgery within the last 2 weeks; arterial puncture at a site not easily compressed for hemostasis within the last 7 days.
- Gastrointestinal or urinary system bleeding within the last 3 weeks.
- Aortic dissection.
- Acute bleeding tendency, including platelet count < 100×10^9/L or other bleeding tendencies.
- Received low-molecular-weight heparin orally within 24 hours; taking warfarin with INR > 1.7 or PT > 15 seconds; used a new oral anticoagulant within 48 hours.
- Blood glucose < 2.8 mmol/L or > 22.2 mmol/L.
- Large area cerebral infarction indicated on head CT or MRI (infarction area > 1/3 of the middle cerebral artery territory).
- Active visceral hemorrhage, known bleeding diathesis or significant bleeding disorders within the past 6 months
- Severe ischemic stroke (NIHSS score > 25)
- Epileptic seizures at the time of stroke onset
- Pregnant or lactating women
- Various terminal diseases with an expected survival of ≤ 3 months
- Any other physical conditions where the doctor deems participation in this study may be detrimental to the patient
- Currently participating in other drug or device clinical trials
- mRS score > 2 before onset of the disease.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Usual BP management group
|
To receive blood pressure management according to standard local guidelines.
In China, for patients scheduled for intravenous thrombolysis who present with elevated blood pressure, it is advised to maintain blood pressure below 180/100 mmHg for 24 hours, after which standard guideline-based blood pressure management should be resumed.
|
|
Experimental: Adjusted BP management group
|
For patients intended to receive intravenous thrombolysis, when the blood pressure ranges from 180/100 mmHg to 200/110 mmHg, simultaneous initiation of both intravenous thrombolysis and antihypertensive treatment can be considered.
If the blood pressure exceeds 200/110 mmHg, antihypertensive treatment should be initiated first.
Intravenous thrombolysis can be commenced after the blood pressure is reduced to below 200/110 mmHg.
Before thrombolysis and within 24 hours after the initiation of intravenous thrombolysis, efforts should be made to control the extent of blood pressure reduction.
When the blood pressure drops below 180/100 mmHg, antihypertensive treatment should be terminated.
Twenty-four hours later, the routine blood pressure management protocol should be reinstated.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The proportion of symptomatic intracranial hemorrhage
Time Frame: Day 1
|
The proportion of symptomatic intracranial hemorrhage within 24 hours after thrombolysis according to ECASS III criteria
|
Day 1
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The proportion of symptomatic intracranial hemorrhage within 24 hours
Time Frame: DAY 1
|
The proportion of symptomatic intracranial hemorrhage within 24 hours after thrombolysis (ECASS II criteria, SIST-MOST criteria, NINDS criteria)
|
DAY 1
|
|
The proportion of intracranial hemorrhage transformation
Time Frame: Day 1
|
The proportion of any intracranial hemorrhage transformation within 24 hours after thrombolysis
|
Day 1
|
|
The proportion of major substantive hemorrhage
Time Frame: The proportion of major substantive hemorrhage occurring within 24 hours after thrombolysis (PH2)
|
The proportion of major substantive hemorrhage occurring within 24 hours after thrombolysis (PH2)
|
|
|
The proportion of severe or life-threatening major hemorrhage
Time Frame: DAY 90
|
The proportion of severe or life-threatening major bleeding (as defined by GUSTO)
|
DAY 90
|
|
time to use of reperfusion treatment
Time Frame: DAY 1
|
Door-to-needle time for intravenous thrombolysis patients
|
DAY 1
|
|
level of physical function
Time Frame: DAY 90
|
Level of function defined across 7 categories of disability on the modified Rankin scale (mRS 0-6) in which scores of 0 or 1 indicate good function without or with symptoms but not disability, socress of 2 indicates slight disability but independence, 3 to 5 indicate increasing levels of disability (and dependency), and a score of 6 indicates death.
|
DAY 90
|
|
death or dependency measured by a shift in mRS
Time Frame: DAY 90
|
Level of function defined across 7 categories of disability on the modified Rankin scale (mRS 0-6) in which scores of 0 or 1 indicate good function without or with symptoms but not disability, socress of 2 indicates slight disability but independence, 3 to 5 indicate increasing levels of disability (and dependency), and a score of 6 indicates death.
|
DAY 90
|
|
Death
Time Frame: DAY 90
|
DAY 90
|
|
|
Neurological function measured by NIHSS
Time Frame: day 7 or at discharge
|
NIHSS score at 7 days or at discharge (if the length of hospital stay is less than 7 days)
|
day 7 or at discharge
|
|
Neurological function measured by mRS
Time Frame: DAY 7 or at discharge
|
mRS score at 7 days or at discharge (if the length of hospital stay is less than 7 days)
|
DAY 7 or at discharge
|
|
number of patients with serious adverse events
Time Frame: DAY 90
|
total number of serious adverse events reported during follow-up, according to standard definitions
|
DAY 90
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- EAST-BP
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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