HOPE BP
(2026)Objective
To test whether an intensive, mTICI-stratified BP-lowering strategy after successful EVT improves 90-day functional outcome compared with standard care in anterior LVO stroke.
Study Summary
• Primary 90-day mRS 0-2: 60.0% vs 46.7% (P=0.005).
• Ordinal mRS: OR 1.43 (1.02-2.00).
• HT 22.3% vs 31.6% (P=0.03); sICH 3.5% vs 3.9% (NS).
• Trial terminated early due to funding restraints.
• Ordinal mRS: OR 1.43 (1.02-2.00).
• HT 22.3% vs 31.6% (P=0.03); sICH 3.5% vs 3.9% (NS).
• Trial terminated early due to funding restraints.
Intervention
Intensive post-EVT BP, target SBP stratified by mTICI (mTICI 2b: 140-160 mmHg; mTICI 2c-3: 100-140 mmHg), maintained 72 h with vasopressors permitted
Inclusion Criteria
Spain. Stroke due to anterior LVO; achieved mTICI 2b-3 after EVT; randomized within 1 h. Excluded patients with untreated intra- or extracranial stenosis.
Study Design
Arms: Intensive mTICI-stratified BP vs standard care (SBP <180/105 mmHg)
Patients per Arm: Intensive n=215 vs Standard n=225 (total 440)
Outcome
• Primary 90-day mRS 0-2: 60.0% vs 46.7% (P=0.005).
• Ordinal mRS: OR 1.43 (1.02-2.00).
• Hemorrhagic transformation: 22.3% vs 31.6% (P=0.03).
• sICH: 3.5% vs 3.9% (NS).
• Ordinal mRS: OR 1.43 (1.02-2.00).
• Hemorrhagic transformation: 22.3% vs 31.6% (P=0.03).
• sICH: 3.5% vs 3.9% (NS).