8 research outputs found
P2.8 Congenital muscular dystrophy with intracytoplasmatic aggregates on muscle biopsy caused by mutation on LMNA gene
No full textVascular Disease Burden, Outcomes and Benefits with Empagliflozin in Heart Failure: Insights From the EMPEROR-Reduced Trial
No full textBackground: The presence of ischemic heart disease impacts prognosis in patients affected by heart failure and reduced ejection fraction (HFrEF). It is not well known how the extent of vascular disease impacts prognoses and responses to therapy in this setting. Methods: In this post hoc analysis of the EMPEROR-Reduced trial, outcomes and the effects of empagliflozin, were assessed in study participants according to the extent (none vs mono1 vs poly [≥ 2] vascular bed) of vascular disease. Vascular disease was defined as investigator-reported coronary artery disease (CAD), peripheral artery disease (PAD) and cerebrovascular disease at baseline. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Incidence rates are presented per 100 person-years (py) of follow-up. Results: Of the 3730 study participants enrolled, 1324 (35.5%) had no vascular disease, 1879 (50.4%) had monovascular disease, and 527 (14.1%) had polyvascular disease. Participants with polyvascular disease tended to be older and male and to have had histories of hypertension, diabetes and smoking. In the placebo arm, a significantly higher risk for cardiovascular death existed in those with polyvascular disease (HR 1.57, 95% CI1.02, 2.44, compared to those with no vascular disease). In adjusted analysis, the benefit of empagliflozin in cardiovascular death or hospitalization due to HF, HF hospitalization, cardiovascular death, renal composite endpoint, estimated glomerular filtration slope changes, and health status scores were seen across the 3 groups (interaction P > 0.05 for all) but were attenuated in those with polyvascular disease. Adverse events were higher in those with polyvascular disease, but no major differences were noted between empagliflozin or placebo assignment in the 3 groups. Conclusion: In patients with HFrEF, the extent of vascular disease is associated with the risk for adverse cardiovascular outcomes. Empagliflozin offers cardiovascular and renal benefits in HFrEF across the extent of vascular disease, but this benefit is attenuated in those with polyvascular disease. © 2023 The Author
STAC3 p.Trp284Ser associated with congenital myopathy with distinctive dysmorphic features and malignant hyperthermia
No full textWell Construction Hydraulics In Challenging Environments [hidráulica De Construção De Poços Em Cenários Críticos]
No full textThis article reports the main R&D efforts on wellbore construction hydraulics which facilitated the technological development of major Brazilian offshore fields in challenging scenarios. These include: deep and ultra deepwater exploratory campaigns, inclined, horizontal and complex trajectory development wells, extended reach wells, long horizontal section wells and drilling through sensitive formations (heavy oil reservoirs, salt zones and fractured carbonates). The relevant scenarios, technical aspects, project development strategies, the history of wellbore hydraulics in the main Petrobras R&D programs, as well as the contribution of Brazilian universities are detailed.42183200Almeida, M., Cisne, L., Calvo, J.C.B., Corá, C.A.G., Drillnig and completions of extend reach high rate deepwater producer well in Campos Basin - Brazil (2002) Annual Deep Offshore Technology International Conference and Exhibition, 14. , New Orleans, L.A. Proceedings. Richardson: Offshore Technology Conference, 2002Alves, I., Aragão, A., Bastos, B., Falcão, J., Fartes, E., Pre-Salt Santos Basin -well construction learning curve acceleration (2009) Offshore Technology Conference, 9. , Houston, Texas. Proceedings. Richardson: Offshore Technology Conference, 2009. OTC 20177-MSAmbros, A.C.D., Vitorassi, P.H., Franco, A.T., Morales, R.E.M., Martins, A.L., Numerical simulation of a viscoelastic flow through a concentric annular - Influence of the Deborah number (2008) Brazilian Congress of Thermal Engineering and Sciences, 12. , Belo Horizonte, MG. Proceedings. Rio de Janeiro: ABCM, 2008Andrade, A.R., Lomba, R.F.T., Martins, A.L., Michel, R.C., Estudo sobre a invasão de filtrado de fluído de perfuração por embebição durante a perfuração de reservatórios de gás (2007) Congresso Brasileiro De Sistemas Particulados - ENEMP, 33. , Aracaju, Sergipe. Proceedings. Sergipe: Universidade Federal de Sergipe, 2007Aragão, A.F.L., Calderón, A., Lomba, R.F.T., Moreira, J.N.V.C., Sá, A.N., Martins, A.L., Quintero, L., Moura, E., Field implementation of Gravel Packing horizontal wells using a solids-free synthetic fluid with alpha-/beta-wave technology (2009) SPE Drilling & Completion, Richardson, 24 (4), p. 7. , Dec. SPE 110440-PAAranha, P.E., Miranda, C.R., Magalhães, J.V.M., Campos, G., Martins, A.L., Braghini, A., Naccache, M.F., Dynamic aspects governing cement plug placement in deepwater wells (2011) IADC/SPE Drilling Conference and Exhibition, , Amsterdam, The Netherlands, Proceedings. Richardson: Society of Petroleum Engineers, 2011. SPE/IADC 140144Avelar, C.S., Ribeiro, P.R., Sepehrnoori, K., Deepwater gas kick simulation (2009) Journal of Petroleum Science and Engineering, Amsterdam, 67 (1-2), pp. 13-22. , JulyBeltrão, R.L.C., Sombra, C.L., Lage, A.C.V.M., Netto, J.R.F., Henriques, C.C.D., Challenges and new technologies for the development of the pre-salt cluster, Santos Basin, Brazil (2009) Offshore Technology Conference, , Houston, Texas. Proceedings. Richardson: Offshore Technology Conference, 2009. OTC 19880-MSCarminatti, M., Dias, J.L., Wolff, B., From turbidites to carbonates: Breaking paradigms in deep waters (2009) Offshore Technology Conference, , Houston, Texas. Proceedings. Richardson: Offshore Technology Conference, 2009. OTC 20124-MSCasanova, L.M.A., (2011) Soluções Analíticas e Numéricas Para Escoamento Laminar de Fluidos Viscoplasticos em Tubos Elípticos, , Dissertação (Mestrado) - Universidade Tecnológica Federal do Paraná, Curitiba, 2011Costa, F.G., Ferreira, M.V.D., Campos, E.F., Macedo, F.S., Aragão, A.F.L., Martins, A.L., An Experimental study to define operational parameters governing hole enlargement while drilling offshore heavy-oil reservoirs (2010) IADC/SPE Drillng Conference and Exhibition, , New Orleans, Louisiana. Proceedings. Houston: International Association of Drilling ContractorsRichardson: Society of Petroleum Engineers, 2010. IADC/SPE 128915-MSCosta, S.S., Stuckenbruck, S., Fontoura, S.A.B., Martins, A.L., Simulation of transient cuttings transportation and ECD in wellbore drilling (2008) EUROPEC/EAGE Conference and Exhibition, p. 9. , Rome, Italy. Proceedings. Richardson: Society of Petroleum Engineers, 2008. SPE 113893-MSDe Lai, F.C., Junqueira, S.L.M., Franco, A.T., Lage, J.L., Natural Convection in a heterogeneous porous cavity: Aspect ratio effects (2010) National Congress of Mechanical Engineering, 6. , Campina Grande. Proceedings. Richardson: Society of Petroleum Engineers, 2010Deepwater drilling (2009) Advanced Drilling and Well Technology, pp. 574-582. , AADNOY, B. S.COOPER, I.MISKA, S. Z.MITCHELL, R. F.PAYNE, M. L. (Org.). Richardson: Society of Petroleum Engineers, Cap. 7Dutra, E.S.S., Martins, A.L., Miranda, C.R., Aragão, A.F.L., Campos, G., Mendes, P.R.S., Naccache, M.F., Dynamics of fluid substitution while drilling and completing long horizontal-section wells (2005) Latin American and Caribbean Petroleum Engineering Conference, p. 8. , Rio de Janeiro, Brazil. Proceedings. Richardson: Society of Petroleum Engineers, 2005. SPE 94623-MSFigueiredo, M.S., Almeida, L.C., Costa, F.G., Clarisse, M.D., Lopes, L.M.A., Lucas, E.F., Leal, R., Martins, A.L., Development of a method to evaluate the performance of aqueous polymer solutions as drag reduction agents in bench scale (2006) Macromolecular Symposia, Hoboken, 245-246 (1), pp. 260-265. , Dec. Special Issue: World Polymer Congress - MACRO 2006Folsta, M.G., Martins, A.L., Lomba, R.F.T., Cardoso, W.F., Simão, C.A., Sidi, I.A., Predicting salt leaching during drilling and cementing operations (2011) SPE/IADC Drilling Conference and Exhibition, p. 10. , Amsterdam, Holanda. Proceedings. Richardson: Society of Petroleum Engineers, 2011. SPE 140242-MSFormigli, J.M., Pinto, A.C.C., Almeida, A.S., Santos basin's pre-salt reservoirs development - The way ahead (2009) Offshore Technology Conference, p. 10. , Houston, Texas. Proceedings. Richardson: Offshore Technology Conference, 2009. OTC19953-MSGandelman, R.A., Waldmann, A.T.A., Martins, A.L., Teixeira, G.T., Aragão, A.F.L., Rezende, M., Mari, A., Field implementation of a real time drilling problem diagnostic for deepwater exploratory wells (2010) Offshore Technology Conference, , Houston, Texas. Proceedings. . Richardson: Offshore Technology Conference, 2010. OTC 20652-MSGomes, F.C., Carvalho, M.S., Lubrication model of the flow of several liquids through an annular space with varying eccentricity (2009) International Congress of Mechanical Engineering - COBEM, 20. , Gramado. Proceedings. Rio de Janeiro: ABCM, 2009Grothe, V.P., Ribeiro, P.R., Sousa, J.L.A.O., Fernandes, P.D., The Study of crosslinked fluids leakoff in physical simulations of hydraulic fracturing (2000) RIO Oil & Gas Conference and Exhibition, , Rio de Janeiro. Proceedings. Rio de Janeiro: IBP, 2000. Paper IBP-02900Kimura, H.F., Ramalho, V.A.O., Negrão, C.O.R., Junqueira, S.L.M., Martins, A.L., Transient mathematical model for the axial annular fluid flow caused by drillpipe motion (2008) Brazilian Congress of Thermal Engineering and Sciences, 12. , Belo Horizonte, MG. Proceedings.Rio de Janeiro: ABCM, 2008Lomba, R., Folsta, M., Cardoso, W., Gonçalves, C.J., Martins, A., Aragão, A., Oliveira, M., Drilling fluids design tools to salt sections drilling (2010) RIO Oil & GáS Expo and Conference, 15. , Rio de Janeiro. Proceedings. Rio de janeiro: IBP, 2010Loureiro, B.V., Magalhães, J.V.M., Ferreira, M.V.D., Calderón, A., Martins, A.L., Santos, F.P., A Comparison of design placement methodologies for horizontal open hole gravel pack in multizone completion projects (2009) Latin American and Caribbean Petroleum Engineering Conference, , Cartagena de Indias, Colombia. Proceedings. . Richardson: Society of Petroleum Engineers, 2009. SPE122064-MSLoureiro, B.V., Magalhães, J.V.M., Ferreira, M.V.D., Calderón, A., Martins, A.L., Santos, F.P., Horizontal open hole gravel pack placement requirements in selective completion projects (2010) European Formation Damage Conference, 8. , Scheveningen, Netherlands. Proceedings. Richardson: Society of Petroleum Engineers, 2010. SPE 122054-MSMagalhães, G.R., (2011) Estudo Experimental de Um Escoamento Bifásico Horizontal Considerando Os Efeitos da Solubilidade da Fase Gasosa, , Dissertação (Mestrado) - Universidade Federal do Rio de Janeiro, COPPE, Rio de Janeiro, 2011Martins, A.L., Magalhães, J.V.M., Ferreira, M.V.D., Calderón, A., Sá, A.N., Sand control in long horizontal section wells (2009) Offshore Technology Conference, , Houston, Texas. Proceedings. Richardson: Offshore Technology Conference, 2009. OTC 20113-MSMartins, A.L., Sa, C.H.M., Lourenço, A.M.F., Freire, L.G.M., Campos, W., Experimental determination of interfacial friction factor in horizontal drilling with a bed of cuttings (1996) SPE Latin America/Caribbean Petroleum Engineering Conference, , Port-of-Spain, Trinidad. Proceedings. Richardson: Society of Petroleum Engineers, 1996. SPE 36075-MSMartins, A.L., Santana, C.C., Evaluation of cuttings transport in horizontal and near horizontal wells - A dimensionless approach (1992) SPE Latin America Petroleum Engineering Conference, , Caracas, Venezuela. Proceedings. Richardson: Society of Petroleum Engineers, 1992. SPE 23643-MSMartins, A.L., Santana, M.L., Campos, W., Gaspari, E.F., Evaluating the transport of solids generated by shale instabilities in ERW drilling (1999) SPE Drilling & Completion, Richardson, 14 (4), pp. 254-259. , Dec. SPE 59729-PADe Souza, M.P.R., Naccache, M.F., Varges, P.R., Marchesini, F.H., Flow of viscoplastic liquids through axisymmetric expansions-contractions (2007) Journal of Non-Newtonian Fluid Mechanics, 142 (1-3), pp. 207-217. , DOI 10.1016/j.jnnfm.2006.09.007, PII S0377025706002679, Viscoplastic fluids: From theory to applicationMonteiro, E.N., Ribeiro, P.R., Lomba, R.F.T., Study of the PVT Properties of gas - Synthetic-drilling-fluid mixtures applied to well control (2010) SPE Drilling & Completion, Richardson, 25 (1), pp. 45-52. , MarMoreno, R.B.Z.L., Bonet, E.J., Waldmann, A.T.A., Martins, A.L., Tayloring filtrate rheology for invasion control in heavy and light oil reservoirs (2009) European Formation Damage Conference, 8. , Scheveningen, The Netherlands. Proceedings. Richardson: Society of Petroleum Engineers, 2009. SPE 122076-MSNegrão, C.O.R., Franco, A.T., Oliveira, G.M., Martins, A.L., Gandelman, R.G., Rocha, L.L.V., Pressure transmission in gelled drilling fluids in deepwater environments (2010) IADC/SPE Drilling Conference and Exhibition, , New Orleans, Louisiana. Proceedings. Richardson: International Association of Drilling Contractors, 2010. SPE128859-MSNelson, R., (2001) Geologic Analysis of Naturally Fractured Reservoirs, p. 352. , 2. ed. Houston: Gulf Professional PublishingNogueira, E.F., Vanni, G.S., Aragão, A.F.L., Fates, E.T.M., MPD Operations in Petrobras - Past, present and future (2011) IADC/SPE Managed Pressure Drilling & Underbalanced Operations Conference & Exhibition, , Denver, Colorado. Proceedings. Richardson: International Association of Drilling Contractors, 2011Paula Jr., R.R., Ribeiro, P.R., Santos, O.L.A., HPHT Drillings new frontiers for well safety (2009) SPE/IADC Drilling Conference and Exhibition, , Amsterdã, Holanda. Proceedings. Richardson: Society of Petroleum Engineers, 2009. SPE 119909-MSPedroso, C., Sanches, E., Oliveira, N., Fernandes, L., Mickelburgh, I.J., Coelho, G.S., New solutions to extend the application window of horizontal openhole Gravel Packing (2005) SPE Annual Technical Conference and Exhibition, , Dallas, Texas. Proceedings. Richardson: Society of Petroleum Engineers, 2005. SPE 96257-MS(2009) Relatório Anual de Sustentabilidade 2009, p. 159. , PETROBRAS. Rio de Janeiro: Petrobras, ComunicaçãoPinto, A.C.C., Branco, C.C.M., Matos, J.S., Vieira, P.M., Guedes, S.S., Pedroso, C., Coelho, A.C.D., Ceciliano, M.M., Offshore heavy oil in Campos Basin: The Petrobras experience (2003) Offshore Technology Conference, , Houston, Texas. Proceedings. Richardson: Offshore Technology Conference, 2003. SPE 15283-MSRibeiro, P.R., Pessôa-Filho, P.A., Lomba, R.F.T., Bonet, E.J., Measurement and modeling of methane dissolution in synthetic liquids applied to drilling fluid formulation for deep and ultradeep water wells (2006) Journal of Petroleum Science and Engineering, Amsterdam, 51 (1-2), pp. 37-44. , AprRossi, L.F.S., Baptista, J.M.M., Morales, R.E.M., Thermodynamic analysis of the formation of hydrates in drilling operations (2006) Brazilian Congress of Thermal Sciences and Engineering - ENCIT, 11. , Curitiba. Proceedings. Rio de Janeiro: ABCM, 2006Sayd, A.D., Moço, A.L.B., Branco, C.C.M., Kato, E.T., Carvalho Jr., I.P., Rosseto, J.A., Silva Neto, J.A., Brasil, T.E., Siri pilot project - First offshore extra heavy and viscous oil (2009) Offshore Technology Conference, , Houston,Texas. Proceedings. Richardson:Offshore Technology Conference, 2009. OTC 20134-MSScheid, C.M.L., Calçada, L.A., Araújo, C.A.O., Waldmann, A.T.A., Martins, A.L.A., Theoretical and experimental analysis of dynamic filtration in drilling operations (2010) SPE International Symposium and Exhibition on Formation Damage Control, , Lafayette, Louisiana. Proceedings. Richardson: Society of Petroleum Engineers, 2009. SPE 128035-MSScheid, C.M., Calçada, L.A., Rocha, D.C., Aranha, P.E., Aragão, A.F.L., Martins, A.L., Prediction of pressure losses in drilling fluid flows in circular and annular pipes and accessories (2009) SPE Latin American and Caribbean Petroleum Engineering Conference, , Cartagena, Colombia. Proceedings. Richardson: Society of Petroleum Engineers, 2009. SPE 122072-MSSilva, M.G.P., Martins, A.L., Evaluation of the Rheological Behavior, Equivalent Diameter and Friction Loss Equations of Fluids in air condition (1988) World Conference on Experimental Heat Transfer, Fluid Mechanics and Thermodynamics, 1. , Dubrovnik, Croatia. Proceedings. New York: Elsevier, 1988Silva, M.G.P., Martins, A.L., Barbosa, B.C., Garcia Jr., H., Designing fluid velocity profiles for optimal primary cementing (1996) SPE Latin America/Caribbean Petroleum Engineering Conference, , Port-of-Spain, Trinidad. Proceedings. Richardson: Society of Petroleum Engineers, 1996. SPE 36136-MSSilveira Neto, A., Padilla, E.L.M., Martins, A.L., Annular flows with variable eccentricity: Preliminary results (2007) Encontro Nacional de HidráUlica de PerfuraçÃo e CompletaçÃo de Poços - ENAHPE, 2. , Teresópolis, Rio de Janeiro. Proceedings. Rio de Janeiro: PUC-Rio, 2007. p. 1-13Souza, J.Z., Ribeiro, D.C., Fontes, C.E., Martins, A.L., Waldmann, A.T.A., Lomba, R.F.T., Análise do escoamento de fluidos particulados durante a perfuração de reservatórios fraturados (2009) Encontro Nacional de Hidráulica De Poços de Petróleo e Gás - ENAHPE, 3. , Campos de Jordão, São Paulo. Proceedings. São Paulo: Universidade Estadual de Campinas, 2009Stuckenbruck, S., Fontoura, S.A.B., Martins, D.Q., Costa, S.S., Martins, A.L., Uma Nova abordagem para a modelagem de suspensão de cascalho no transporte em dutos (2009) Encontro Nacional de Hidráulica de Poços de Petróleo e Gás - ENAHPE, 3. , Campos de Jordão, São Paulo. Proceedings. São Paulo: Universidade Estadual de Campinas, 2009Thonhauser, G., Millheim, K., Martins, A.L., Cuttings flux measurement and analysis for extended-reach wells (1999) SPE/IADC Drilling Conference, , Amsterdã, Holanda. Proceedings. Richardson: Society of Petroleum Engineers, 1999. SPE 52793-MSVarges, P.R., Mendes, P.R.S., Emídio, P., Waldmann, A., Martins, A., Liquid-liquid displacement flows in a hele-shaw cell including non-newtonian effects (2010) Brazilian Conference on Rheology, 5. , Rio de Janeiro. Proceedings. Rio de Janeiro: ABCM, 2010Vega, M., Martins, A., Fred Folsta, M., Experimental and theoretical study of control strategies for constant bottomhole pressure while drilling oil wells (2011) IADC/SPE Managed Pressure Drilling and Underbalanced Operations Conference & Exhibition, , Denver, Colorado. Proceedings. Richardson: Society of Petroleum Engineers, 2011. SPE 143098-MSWaldmann, A.T.A., Martins, A.L., Aragão, A.F.L., Lomba, R.F.T., Predicting and monitoring fluid invasion in exploratory drilling (2005) SPE Drilling & Completion, Richardson, 20 (4), pp. 268-275. , Dec. SPE 86497-P
Pathogenic TNNI1 variants disrupt sarcomere contractility resulting in hypo- and hypercontractile muscle disease
No full textTroponin I (TnI) regulates thin filament activation and muscle contraction. Two isoforms, TnI-fast (TNNI2) and TnI-slow (TNNI1), are predominantly expressed in fast- and slow-twitch myofibers, respectively. TNNI2 variants are a rare cause of arthrogryposis, whereas TNNI1 variants have not been conclusively established to cause skeletal myopathy. We identified recessive loss-of-function TNNI1 variants as well as dominant gain-of-function TNNI1 variants as a cause of muscle disease, each with distinct physiological consequences and disease mechanisms. We identified three families with biallelic TNNI1 variants (F1: p.R14H/c.190-9G>A, F2 and F3: homozygous p.R14C), resulting in loss of function, manifesting with early-onset progressive muscle weakness and rod formation on histology. We also identified two families with a dominantly acting heterozygous TNNI1 variant (F4: p.R174Q and F5: p.K176del), resulting in gain of function, manifesting with muscle cramping, myalgias, and rod formation in F5. In zebrafish, TnI proteins with either of the missense variants (p.R14H; p.R174Q) incorporated into thin filaments. Molecular dynamics simulations suggested that the loss-of-function p.R14H variant decouples TnI from TnC, which was supported by functional studies showing a reduced force response of sarcomeres to submaximal [Ca2+] in patient myofibers. This contractile deficit could be reversed by a slow skeletal muscle troponin activator. In contrast, patient myofibers with the gain-of-function p.R174Q variant showed an increased force to submaximal [Ca2+], which was reversed by the small-molecule drug mavacamten. Our findings demonstrated that TNNI1 variants can cause muscle disease with variant-specific pathomechanisms, manifesting as either a hypo- or a hypercontractile phenotype, suggesting rational therapeutic strategies for each mechanism
Intracerebral hemorrhage location and outcome among INTERACT2 participants
No full textObjective: To clarify associations between intracerebral hemorrhage (ICH) location and clinical outcomes among participants of the main phase Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).
Methods: Associations between ICH sites and poor outcomes (death [6] or major disability [3–5] of modified Rankin Scale) and European Quality of Life Scale (EQ-5D) utility scores at 90 days were assessed in logistic regression models.
Results: Of 2,066 patients included in the analyses, associations were identified between ICH sites and poor outcomes: involvement of posterior limb of internal capsule increased risks of death or major disability (odds ratio [OR] 2.10) and disability (OR 1.81); thalamic involvement increased risks of death or major disability (OR 2.24) and death (OR 1.97). Involvement of the posterior limb of the internal capsule, thalamus, and infratentorial sites were each associated with poor EQ-5D utility score (≤0.7 [median]; OR 1.87, 2.14, and 2.81, respectively). Posterior limb of internal capsule involvement was strongly associated with low scores across all health-related quality of life domains. ICH encompassing the thalamus and posterior limb of internal capsule were associated with death or major disability, major disability, and poor EQ-5D utility score (OR 1.72, 2.26, and 1.71, respectively).
Conclusion: Poor clinical outcomes are related to ICH affecting the posterior limb of internal capsule, thalamus, and infratentorial sites. The highest association with death or major disability and poor EQ-5D utility score was seen in ICH encompassing the thalamus and posterior limb of internal capsule.
ClinicalTrials.gov registration: NCT00716079
Estimated GFR and the Effect of Intensive Blood Pressure Lowering After Acute Intracerebral Hemorrhage
No full textBackgroundThe kidney-brain interaction has been a topic of growing interest. Past studies of the effect of kidney function on intracerebral hemorrhage (ICH) outcomes have yielded inconsistent findings. Although the second, main phase of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) suggests the effectiveness of early intensive blood pressure (BP) lowering in improving functional recovery after ICH, the balance of potential benefits and harms of this treatment in those with decreased kidney function remains uncertain.Study DesignSecondary analysis of INTERACT2, which randomly assigned patients with ICH with elevated systolic BP (SBP) to intensive (target SBP<140mmHg) or contemporaneous guideline-based (target SBP<180mmHg) BP management.Setting & Participants2,823 patients from 144 clinical hospitals in 21 countries.PredictorsAdmission estimated glomerular filtration rates (eGFRs) of patients were categorized into 3 groups based on the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine equation: normal or high, mildly decreased, and moderately to severely decreased (>90, 60-90, and <60mL/min/1.73m2, respectively).OutcomesThe effect of admission eGFR on the primary outcome of death or major disability at 90 days (defined as modified Rankin Scale scores of 3-6) was analyzed using a multivariable logistic regression model. Potential effect modification of intensive BP lowering treatment by admission eGFR was assessed by interaction terms.ResultsOf 2,623 included participants, 912 (35%) and 280 (11%) had mildly and moderately/severely decreased eGFRs, respectively. Patients with moderately/severely decreased eGFRs had the greatest risk for death or major disability at 90 days (adjusted OR, 1.82; 95% CI, 1.28-2.61). Effects of early intensive BP lowering were consistent across different eGFRs (P=0.5 for homogeneity).LimitationsGeneralizability issues arising from a clinical trial population.ConclusionsDecreased eGFR predicts poor outcome in acute ICH. Early intensive BP lowering provides similar treatment effects in patients with ICH with decreased eGFRs
