B_PROUD is actually a study in the prehospital setting of stroke where we compare patients for whom a mobile stroke unit, so an ambulance with a CT scanner on board and a neurologist on board, was dispatched and compared to a normal ambulance dispatch. The B_PROUD study showed that there was a significant and very obvious benefit for patients with ischemic stroke, but this time actually we will present the data for hemorrhagic strokes...
B_PROUD is actually a study in the prehospital setting of stroke where we compare patients for whom a mobile stroke unit, so an ambulance with a CT scanner on board and a neurologist on board, was dispatched and compared to a normal ambulance dispatch. The B_PROUD study showed that there was a significant and very obvious benefit for patients with ischemic stroke, but this time actually we will present the data for hemorrhagic strokes. There are no evidence-based treatments for hemorrhagic strokes at the moment, but our hope was that with earlier diagnosis of hemorrhagic stroke, so with the CT on the mobile stroke unit, we would be able to treat patients earlier with blood pressure lowering and also with reversal of oral anticoagulation.
What we see is actually that we were actually quite effective in lowering blood pressure, so the blood pressure at hospital arrivals were much lower in the group of mobile stroke unit care. But again, this system did not translate in around 200 patients who were included in this study into better outcome. It was more or less neutral effect, and when we look at patients who have a very high blood pressure, so higher than 180 systolic blood pressure at ambulance arrival, it even looks that early aggressive blood pressure lowering might be harmful for the patients.
So this is an interesting finding, actually it is a little bit in line with other studies like the RIGHT-2 study also with blood pressure lowering. I think this needs to be further evaluated in other studies, in other MSU studies, because normal interventional studies in stroke only include patients after hospital arrival. So this is really interesting that in the prehospital setting, it might be actually dangerous for the patient to get aggressive blood pressure lowering.