Evidence mapPaperPMID 34210824Full record

Trial reportNeurology2021

Impact of Renal Impairment on Intensive Blood-Pressure-Lowering Therapy and Outcomes in Intracerebral Hemorrhage: Results From ATACH-2.

Mayumi Fukuda-Doi, Haruko Yamamoto, Masatoshi Koga, Yohei Doi, Adnan I Qureshi, Sohei Yoshimura, Kaori Miwa, Akiko Ishigami, Masayuki Shiozawa, Katsuhiro Omae and 2 more

Registry-linked trialOpen access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01176565 (Antihypertensive Treatment of Acute Cerebral Hemorrhage), which is not on this map. Cited by 19 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 3 pooled it
1.7field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01176565 phase3terminatednot on this map

Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-II: A Phase III Randomized Multicenter Clinical Trial of Blood Pressure Reduction for Hypertension in Acute Intracerebral Hemorrhage

TypeinterventionalSponsorUniversity of MinnesotaRan2011 to 2016Enrolled1,000ConditionsIntracerebral HemorrhageArmsIntravenous nicardipine hydrochloride
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
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  4. Blood pressure variability in the ATACH2 study: evaluating a target range.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 2 countries.

Mayumi Fukuda-DoiFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.ORCID 0000-0003-0922-4417
Haruko YamamotoFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.
Masatoshi KogaFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.
Yohei DoiFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.
Adnan I QureshiFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.
Sohei YoshimuraFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.
Kaori MiwaFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.ORCID 0000-0002-7948-3636
Akiko IshigamiFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.
Masayuki ShiozawaFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.
Katsuhiro OmaeFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.
Masafumi IharaFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia.ORCID 0000-0002-7102-4048
Kazunori ToyodaFrom the Departments of Cerebrovascular Medicine (M.F.-D., M.K., S.Y., K.M., A.I., M.S., K.T.), Data Science (M.F.-D., H.Y., K.O.), and Neurology (M.I.), National Cerebral and Cardiovascular Center; Department of Nephrology (Y.D.), Osaka University Graduate School of Medicine, Suita, Japan; Zeenat Qureshi Stroke Institute (A.I.Q.), St. Cloud, MN; and Department of Neurology (A.I.Q.), University of Missouri, Columbia. toyoda@ncvc.go.jp.
National Cerebral and Cardiovascular Center · JP

Funding

NINDS NIH HHS U01 NS059041NINDS NIH HHS U01 NS061861NINDS NIH HHS U01 NS062091
6 · The paper itself

Abstract

BACKGROUND AND

objectiveThe clinical effect of renal impairment on intracerebral hemorrhage (ICH) is unknown. This study sought to assess whether estimated glomerular filtration rate (eGFR) affects clinical outcomes or modifies the efficacy of intensive systolic blood pressure (BP) control (target, 110-139 mm Hg) against the standard (target, 140-179 mm Hg) among patients with ICH.

methodsWe conducted post hoc analyses of ATACH-2, a randomized, 2-group, open-label trial. The baseline eGFR of each eligible patient was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. The outcome of interest was death or disability at 90 days. Multivariate logistic regression models were used for analysis.

resultsAmong the 1,000 patients randomized, 974 were analyzed. The median baseline eGFR was 88 (interquartile range, 68, 99) mL/min/1.73 m DISCUSSION: Decreased eGFR is associated with unfavorable outcomes following ICH. The statistically significant interaction between the eGFR group and treatment assignment raised safety concerns for the intensive BP-lowering therapy among patients with renal impairment. TRIAL REGISTRATION INFORMATION: Clinicaltrials.gov identifier: NCT01176565. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in spontaneous ICH, decreased eGFR identifies patients at risk of death or disability following intensive BP control.

Indexed as

AgedAntihypertensive AgentsBlood PressureCerebral HemorrhageFemaleGlomerular Filtration RateHumansMaleMiddle AgedNicardipineRenal InsufficiencyTreatment OutcomeAntihypertensive AgentsNicardipine

Identifiers

PMID34210824
PMCPMC8408509
OpenAlexW3176416860

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.