Evidence map›Paper›PMID 39212990›Full record

Trial reportJAMA network open2024

Early vs Delayed Antihypertensive Treatment in Acute Single Subcortical Infarction: A Secondary Analysis of the CATIS-2 Randomized Clinical Trial.

Yufei Wei, Xuewei Xie, Yuesong Pan, Mengxing Wang, Aili Wang, Dacheng Liu, Zilin Zhao, Ximing Nie, Wanying Duan, Xin Liu and 19 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03479554 (China Antihypertensive Trial in Acute Ischemic Stroke II), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT03479554 phase3completednot on this map

China Antihypertensive Trial in Acute Ischemic Stroke II

TypeinterventionalSponsorTulane UniversityRan2018 to 2023Enrolled4,810ConditionsAcute Ischemic StrokeArmsEarly antihypertensive treatment, Delayed antihypertensive treatment
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

29 authors.

Yufei WeiDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xuewei XieDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yuesong PanDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Mengxing WangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Aili WangDepartment of Epidemiology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
Dacheng LiuDepartment of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Zilin ZhaoDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Ximing NieDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Wanying DuanDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xin LiuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Zhe ZhangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jingyi LiuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Lina ZhengDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Suwen ShenDepartment of Epidemiology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
Chongke ZhongDepartment of Epidemiology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
Tan XuDepartment of Epidemiology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
Yong JiangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jing JingDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xia MengDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Katherine ObstDepartment of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
Chung-Shiuan ChenDepartment of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
Hao LiDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xinyi LengDepartment of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China.
David WangNeurovascular Division, Department of Neurology, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona.
Yilong WangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yonghong ZhangDepartment of Epidemiology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
Jiang HeDepartment of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
Yongjun WangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Liping LiuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The China Antihypertensive Trial in Acute Ischemic Stroke II (CATIS-2) suggests that early antihypertensive treatment did not reduce the risk of dependency or death in acute ischemic stroke (AIS), compared with delayed treatment. Single subcortical infarction (SSI) is an important stroke subtype, and the association of antihypertensive timing with clinical outcomes is unclear. Objective: To investigate the association of early vs delayed antihypertensive treatment with clinical outcomes in patients with SSI, stratified by the presence of parent artery disease (PAD) stenosis. Design, Setting, and Participants: This secondary analysis of the CATIS-2 randomized clinical trial included 106 hospitals in China between June 2018 and July 2022. In CATIS-2, patients with AIS within 24 to 48 hours of symptoms onset and elevated systolic blood pressure were eligible. Patients with SSI detected in diffusion-weighted imaging were included in the current post hoc subgroup analysis. Patients were grouped into (1) SSI with PAD stenosis and (2) SSI without PAD stenosis. Statistical analysis was performed from July 2023 to May 2024. Exposures: Early (immediate) vs delayed (starting on day 8) antihypertensive therapy. Main Outcome and Measure: Primary outcome was the combination of functional dependency or death (modified Rankin Scale score ≥3) at 90 days. Results: Among 997 patients with SSI in CATIS-2 (mean [SD] age, 62.4 [9.8] years; 612 [61.4%] men), 116 (11.6%) had SSI with PAD and 881 (88.4%) had SSI without PAD. There was no significant difference in the primary outcome between early and delayed antihypertensive treatment groups among all patients with SSI (8.8% vs 7.1%; OR, 1.25 [95% CI, 0.79-1.99]; P = .34). Among patients with SSI with PAD, early antihypertensive treatment was associated with increased risk of the primary outcome compared with delayed treatment (23.4% vs 7.7%; OR, 3.67 [95% CI, 1.14-11.86]; P = .03); this finding was not observed in patients with SSI without PAD (6.6% vs 7.1%; OR, 0.93 [95% CI, 0.55-1.57]; P = .77). Significant interaction with treatment and presence of PAD stenosis was detected for the primary outcome (P for interaction = .04). Conclusions and Relevance: In this secondary analysis of a randomized clinical trial, early antihypertensive treatment was associated with an increased risk of functional dependency or death at 90 days among patients with SSI and coexisting PAD stenosis, compared with delayed antihypertensive treatment. Further studies are warranted for individualized BP management in patients with SSI by the presence of PAD. Trial Registration: ClinicalTrials.gov Identifier: NCT03479554.

Indexed as

Antihypertensive AgentsTime-to-TreatmentAgedCerebral InfarctionChinaFemaleHumansHypertensionIschemic StrokeMaleMiddle AgedTime FactorsTreatment OutcomeAntihypertensive Agents

Identifiers

PMID39212990
PMCPMC11365005

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.