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Safety and Efficacy of Therapeutic INduced HYPERTENSION in Acute Non-cardioembolic Ischemic Stroke (SETIN-HYPERTENSION)

Phase 3
Conditions
Stroke, Acute
Progressing Stroke
Interventions
Registration Number
NCT01600235
Lead Sponsor
Samsung Medical Center
Brief Summary

The purpose of this study is to evaluate the safety and efficacy of the induced hypertension using phenylephrine in patients with noncardioembolic ischemic stroke.

The investigators hypothesized that phenylephrine induced-hypertension can result in good clinical response without serious complications in patients with noncardioembolic ischemic stroke.

Detailed Description

See below

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
170
Inclusion Criteria
  • Patients with acute ischemic stroke confirmed by diffusion-weighted imaging (DWI) performed within 24 hours of symptom onset or symptom worsening(defined by a 2-point or more increase in NIH stroke scale (NIHSS)score including one or more increase in the motor score of affected upper and lower limbs in NIHSS during hospitalization or clear history of symptom worsening judged by investigator before hospitalization) confirmed by DWI performed within 24 hours of aggravation.
  • Baseline NIHSS score 4-18 points
  • Alert mental status
  • Newly developed paresis, aphasia, or neglect
Exclusion Criteria
  • Patients underwent recanalization therapy
  • Systolic blood pressure >170 mmHg at baseline
  • Patients with history or at risk of hemorrhagic stroke
  • History of significant arrhythmia (e.g. atrial fibrillation)
  • Unable to perform MRI scans or undergo MRI scans > 24 hours of symptom onset or progression
  • Large cortical infarction on DWI (more than 1/2 of middle cerebral artery territory)
  • 3 or more cortical microbleeds on gradient-echo MRI
  • Coronary artery disease, congestive heart failure, or hypertrophic cardiomyopathy
  • Anticoagulation therapy (phenylephrine group only)
  • Patients with high-risk cardioembolic sources
  • Cervical or cerebral artery dissection or unruptured aortic/cerebral arterial aneurysm
  • Decreased consciousness
  • Pregnant or Lactating patient
  • Seizure at stroke onset
  • Life expectancy < 6 months
  • Pre-stroke modified Rankin scale (mRS) >= 2
  • Patients without informed consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PhenylephrinePhenylephrinePhenylephrine induced-hypertension arm
Primary Outcome Measures
NameTimeMethod
Primary outcomeDay 0 and Day 7

2 points improvement in NIH stroke scale (NIHSS) between days 0 and 7

Secondary Outcome Measures
NameTimeMethod
Minor safety outcomeFrom date of randomization until the date of first documented intracranial hemorrhage on follow-up MRI, or date of first documented side effects, whichever came first, assessed up to 3 months

1. Intracranial hemorrhage on follow-up MRI

2. Side effects including headache, arrhythmia, chest pain, dysuria, or gastrointestinal hemorrhage

Secondary efficacy outcomeDay 90 for 1, 2 and Day 7 for 3

1. modified Rankin scale (mRS)≤ 2 at day 90

2. modified Bathel index (mBI)≥ 90 at day 90

3. Infarct growth or new ischemic lesion on follow-up MRI

Major safety outcomeFrom date of randomization until the date of first documented progression by intracranial hemorrhage or cerebral edema, date of myocardial infarction, or date of death from any cause, whichever came first, assessed up to 3 months

1. Symptom aggravation by intracranial hemorrhage or cerebral edema (Clinical deterioration causing an increase in the NIHSS score of more than or equal to 4 points and if the hemorrhage or edema was liley to be the cause of the clinical deterioration)

2. Myocardial infarction

3. death from any cause

Trial Locations

Locations (1)

Samsung Medical Center, Sungkyunkwan University School of Medicine

🇰🇷

Seoul, Korea, Republic of

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