Body Weight in Relation to the Effectiveness of Intravenous Alteplase in Acute Ischemic Stroke: The ENCHANTED Trial.
StrokeAug 26, 2026 (epub)
Yilun Ge, Yijie Gao, Xiaoying Chen et al.
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In 30 seconds
This post hoc analysis of the ENCHANTED trial evaluated the impact of body weight on the effectiveness of low- versus standard-dose intravenous alteplase in 4,458 patients with acute ischemic stroke. The study found that body weight did not significantly modify treatment effects, but patients weighing less than 74 kg had a higher likelihood of poor functional outcomes (odds ratio, 1.41).
Key findings
- Body weight did not significantly modify the effects of low- versus standard-dose alteplase (P interaction = 0.60).
- Patients weighing <74 kg had a higher likelihood of poor functional outcome (odds ratio, 1.41).
- Patients weighing <74 kg also had a higher likelihood of death (odds ratio, 1.65).
- No increase in symptomatic intracerebral hemorrhage was observed in low-weight patients.
Why it matters
Understanding the relationship between body weight and treatment outcomes in acute ischemic stroke can help clinicians better assess risks and benefits of thrombolysis, particularly in underweight patients who may face poorer functional recovery.