Trial reportJournal of thrombosis and thrombolysis2026
Blood pressure in the first 6 hours for older adults with stroke after endovascular therapy: a pooled analysis of the DEVT and RESCUE BT randomized clinical trials.
Trial report in Journal of thrombosis and thrombolysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Optimal systolic blood pressure (SBP) targets after endovascular therapy (EVT) for stroke in older adults (≥ 65 years) remain undefined. This study assessed age-stratified associations between early post-EVT SBP (first 6 h) and outcomes. Post hoc analysis of two trials. Patients were stratified by age (18-64 vs. ≥ 65 years) and SBP (≤ 120, 120-140, > 140 mmHg). Primary outcome was 90-day functional status (modified Rankin Scale, mRS). Inverse probability treatment weighting (IPTW) and multivariable regression adjusted for confounders. Post-EVT SBP data were available for 267 young and 395 old patients. IPTW analysis revealed that sustained SBP below 120 mmHg during the first 6 h post-EVT significantly enhanced functional independence in elderly patients (common OR: 2.00; 95% CI: 1.18-3.39). Among young cohorts, maintenance of SBP ≤ 120 mmHg (cOR, 2.89; 95% CI, 1.45-5.82) and 120-140 mmHg (cOR, 3.18; 95% CI, 1.58-6.47) were associated with a better outcome. sICH incidence demonstrated no statistically significant association with systolic blood pressure (SBP) levels (P = 0.21; 95% CI: 0.93-1.35). During the initial 6-h window post-EVT, younger patients with SBP ≤ 140 mmHg and elderly patients with SBP ≤ 120 mmHg were associated with favorable outcome. These results suggest that stricter blood pressure control may be particularly beneficial for older adults in the early post-EVT phase.Trial Registration: The DEVT registration: URL: http://www.chictr.org.cn ; Chinese Clinical Trial Registry: ChiCTR-IOR-17013568, and the RESCUE BT registration: URL: http://www.chictr.org.cn ; ChiCTR-INR-17014167.
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