{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T22:34:34Z","timestamp":1768516474916,"version":"3.49.0"},"reference-count":26,"publisher":"BMJ","issue":"2","funder":[{"name":"National Council for Scientific and Technological Development of Brazil"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stroke Association of the United Kingdom"},{"name":"the Ministry for Health, Welfare and Family Affairs of the Republic of Korea"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2017,4,2]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The characteristics of patients with acute ischaemic stroke (AIS) and their management vary across regions, which may influence outcomes. We examined for differential patterns of outcome between China and non-China participants of the ENhanced Control of Hypertension And Thrombolysis strokE stuDy (ENCHANTED), which tested different alteplase doses in AIS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>ENCHANTED was an international, multicentre, open, blinded-endpoint trial of the effects of low-dose (0.6\u2009mg\/kg) versus standard-dose (0.9\u2009mg\/kg) intravenous alteplase on 90-day disability outcomes and symptomatic intracerebral haemorrhage (sICH) in 3310 patients with AIS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Participants (n=1419, 48%) in China were younger, and more often male, hypertensive and with prior stroke and coronary artery disease, but less likely to have atrial fibrillation and use antihypertensive, antithrombotic and lipid-lowering agents, compared with non-China patients with AIS. Although China participants had more AIS due to large artery occlusion, were treated later and had differing ancillary management, there was no significant difference in 90-day modified Rankin scale scores 2\u20136 (55.6% vs 47.8%; OR, adjusted for baseline and management factors 0.87 (95% CI 0.71 to 1.07; p=0.20)) and risk of sICH (Safe Implementation of Thrombolysis in Stroke-Monitoring Study criteria: 1.4% vs 1.8%; p=0.12) compared with non-China participants. There was no heterogeneity in the treatment effects of low-dose versus standard-dose alteplase between China and non-China participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients with AIS recruited to the ENCHANTED trial in China had similar outcomes in response to thrombolysis treatment despite significantly differing demographic, clinical and management factors to patients with AIS in other regions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/svn-2017-000085","type":"journal-article","created":{"date-parts":[[2017,5,22]],"date-time":"2017-05-22T20:10:57Z","timestamp":1495483857000},"page":"53-58","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Characteristics, management and response to alteplase in China versus non-China participants of the ENCHANTED trial"],"prefix":"10.1136","volume":"2","author":[{"given":"Lily","family":"Song","sequence":"first","affiliation":[{"name":"The George Institute for Global Health at Peking University Health Science Center, Beijing, China"},{"name":"Department of Neurology, 85 Hospital of People\u2019s Liberation Army, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Wang","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, The University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thompson","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Sciences, University of Leicester, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard I","family":"Lindley","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, The University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisatomi","family":"Arima","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, The University of New South Wales, Sydney, Australia"},{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo M","family":"Lavados","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago, Universidad del Desarrollo, Concepci\u00f3n, Chile"},{"name":"Departamento de Ciencias Neurol\u00f3gicas, Facultad de Medicina, Universidad de Chile, Concepci\u00f3n, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoying","family":"Chen","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, The University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Chalmers","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, The University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig S","family":"Anderson","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health at Peking University Health Science Center, Beijing, China"},{"name":"The George Institute for Global Health, The University of New South Wales, Sydney, Australia"},{"name":"Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,5,22]]},"reference":[{"key":"2025082410310985000_2.2.53.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70004-2"},{"key":"2025082410310985000_2.2.53.2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.003508"},{"key":"2025082410310985000_2.2.53.3","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.586909"},{"key":"2025082410310985000_2.2.53.4","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e318284056a"},{"key":"2025082410310985000_2.2.53.5","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000086"},{"key":"2025082410310985000_2.2.53.6","doi-asserted-by":"publisher","DOI":"10.1159\/000131083"},{"key":"2025082410310985000_2.2.53.7","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.604249"},{"key":"2025082410310985000_2.2.53.8","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12602"},{"key":"2025082410310985000_2.2.53.9","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12486"},{"key":"2025082410310985000_2.2.53.10","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1056\/NEJMoa1515510","article-title":"Low-dose 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