Abstract WP243: Randomized Clinical Trial Evaluating the Safety and Feasibility of Intensive Lowering of Blood Pressure in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis and Assessed using CT Perfusion Imaging
Bibliographic record
Abstract
Introduction: Uncertainty persists over the optimal management of blood pressure (BP) in the early phase of acute ischemic stroke (AIS). This study aims to determine the safety and effects of intensive BP lowering on cerebral blood flow and functional outcomes in AIS patients treated with intravenous thrombolysis. Methods: In a randomized controlled trial, AIS patients with a systolic BP of 160-180mmHg were randomized to early intensive BP lowering (systolic target range 140-160mmHg) or guideline-based BP management (systolic range 160-180mmHg) during first 72-hours using primarily intravenous labetalol. All study subjects underwent CT perfusion at baseline, 24 and 72-hours post-randomization to evaluate change in cerebral hemodynamics. Clinical outcome was assessed using a dichotomized modified Rankin scale (scores 0-1 as excellent outcome versus scores 2-6 as poor outcome) at 90 days. Results: Of the 48 recruited patients, 25 (52%) were assigned to the early intensive BP lowering arm and 23 (48%) to the guideline-based BP management arm. Excellent functional outcome at 90 days were similar in the 2 arms- 56% in the early intensive BP lowering arm and 61% in the standard therapy arm. There were no significant differences in the baseline, 24 and 72-hour CT perfusion cerebral hemodynamic parameters or symptomatic intracranial hemorrhage between the 2 study arms. Conclusions: In the early phase of AIS, intensive BP lowering appears to be a safe strategy. Large randomized controlled trials are needed to confirm our study findings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".