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WSC 2023 | INTERACT3 trial mechanistic sub-study: impact of the care bundle on hematoma expansion

Lili Song, MD, PhD, The George Institute for Global Health China, Beijing, China, presents the results of a mechanistic sub-study undertaken as part of the INTERACT3 trial (NCT03209258), focusing on hematoma changes. The international, multicenter, randomized clinical trial, INTERACT3, demonstrated that a goal-directed care bundle protocol yielded better patient outcomes than the standard of care approach for patients with acute intracerebral hemorrhage (ICH). This care bundle protocol included early intensive blood pressure reduction, managing hyperglycemia, treating pyrexia, and reversing anticoagulation. To investigate the mechanism behind the care bundle’s positive effects, a mechanistic sub-study was conducted, analyzing CT scans to assess hematoma volume changes. The primary outcome of change in hematoma volume over 24 hours showed no significant difference between patients in the care bundle and standard care groups, which was also consistent for the secondary outcome of hematoma change at 7 days. Additionally, no significant interactions were found between subgroups and hematoma volume. These results suggest that the care bundle’s effects may be independent of hematoma volume, and further research is needed to explore this relationship. This interview took place at the World Stroke Congress (WSC) 2023 in Toronto, Canada.

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