Efficacy of nitric oxide in stroke

Conditions

Acute stroke Circulatory System Stroke, not specified as haemorrhage or infarction

Jason P. Appleton, Lisa J Woodhouse, Alessandro Adami, Jennifer Becker, Eivind Berge et al. (17 authors)

Neurology2019-12-28140 citations

10.1212/wnl.0000000000008881

Data from: Imaging markers of small vessel disease and ‘brain frailty’ and outcomes in acute stroke

Jason P. Appleton, Lisa J Woodhouse, Alessandro Adami, Jennifer Becker, Eivind Berge et al. (16 authors)

DRYAD2019-06-03

10.5061/dryad.6552r2b

Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial.

Woodhouse LJ, Scutt P, Hamdy S, Smithard DG, Cohen DL, Roffe C, Bereczki D, Berge E, Bladin CF, Caso V, Christensen HK, Collins R, Czlonkowska A, de Silva A, Etribi A, Laska AC, Ntaios G, Ozturk S, Phillips SJ, Prasad K, Szatmari S, Sprigg N, Bath PM.

2017-08-0212 citations

10.1007/s12975-017-0548-0

Infections Up to 76 Days After Stroke Increase Disability and Death

Annastazia Learoyd, Lisa J Woodhouse, Laurence Shaw, Nikola Sprigg, Dániel Bereczki et al. (23 authors)

Translational Stroke Research2017-07-2735 citations

10.1007/s12975-017-0553-3

Glyceryl Trinitrate for Acute Intracerebral Hemorrhage

Kailash Krishnan, Polly Scutt, Lisa J Woodhouse, Alessandro Adami, Jennifer Becker et al. (26 authors)

Stroke2015-12-0941 citations

10.1161/strokeaha.115.010368

Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial

Kailash Krishnan, S. F. Mukhtar, James Lingard, Aimee E. Houlton, Elizabeth Walker et al. (15 authors)

Journal of Neurology Neurosurgery & Psychiatry2015-01-0940 citations

10.1136/jnnp-2014-309845

Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial.

ENOS Trial Investigators.

2014-10-21235 citations

10.1016/s0140-6736(14)61121-1

Very Low Quality of Life After Acute Stroke

Nikola Sprigg, James W. Selby, Lydia Fox, Eivind Berge, David K. Whynes et al. (6 authors)

Stroke2013-10-2347 citations

10.1161/strokeaha.113.002201

Determining the Feasibility of Ambulance-Based Randomised Controlled Trials in Patients with Ultra-Acute Stroke: Study Protocol for the "Rapid Intervention with GTN in Hypertensive Stroke Trial" (RIGHT, ISRCTN66434824).

Ankolekar S, Sare G, Geeganage C, Fuller M, Stokes L, Sprigg N, Parry R, Siriwardena AN, Bath PM.

2012-10-168 citations

10.1155/2012/385753

Interventions

1. Glyceryl trinitrate (transdermal) 2. Continue/temporarily stop prior anti-hypertensive therapy

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Patients with acute ischaemic or haemorrhagic stroke within 48 hours 2. Systolic blood pressure 140-220 mmHg

Exclusion criteria

Exclusion criteria: 1. Unconscious (Glasgow Coma Scale less than eight) 2. Definite need for nitrate therapy: concurrent myocardial infarction, unstable angina, left ventricular failure 3. Dehydration 4. Contraindication to nitrate therapy: hypersensitivity to nitrates, hypovolaemia, hypertrophic obstructive cardiomyopathy, aortic stenosis, cardiac tamponade, constrictive pericarditis, mitral stenosis, marked anaemia, closed-angle glaucoma, sildenafil (Viagra) within previous 24 hours 5. Systolic blood pressure less than 140 mmHg or more than 220 mmHg 6. Patients expected to require surgical intervention (e.g. clot evacuation, carotid endarterectomy) during the treatment or follow-up period 7. Refusal to consent 8. Patient dependent on others prior to stroke (e.g. Rankin score more than three) 9. Known intracerebral pathology other than ischaemic stroke, e.g. subarachnoid haemorrhage, brain tumour, cerebral abscess 10. Other serious condition which is likely to prevent outcome assessment, e.g. advanced cancer 11. Involvement in a trial of another experimental intervention (drug or surgery) for acute stroke 12. Not available for follow-up, e.g. no fixed address, overseas visitor 13. Females of childbearing potential, pregnancy or breastfeeding

Design outcomes

Primary

Measure	Time frame
Death and dependency (Rankin score more than two).	—

Secondary

Measure	Time frame
1. Events by 7 days - recurrent stroke, symptomatic deep vein thrombosis, symptomatic pulmonary embolism, blood pressure daily between 1 and 7 days 2. Hospital events - length of stay in hospital, discharge disposition (death, institution or home) 3. Outcome at 90 days - Barthel Index (less than 60, including death), Barthel Index more than 95/100 at three months (good outcome), quality of life (EuroQol), abbreviated mental test score 4. Safety measures - death at 7 and 90 days, symptomatic intracranial haemorrhage at 7 days, major extracranial haemorrhage at 10 days	—

Measure

Time frame

1. Events by 7 days - recurrent stroke, symptomatic deep vein thrombosis, symptomatic pulmonary embolism, blood pressure daily between 1 and 7 days 2. Hospital events - length of stay in hospital, discharge disposition (death, institution or home) 3. Outcome at 90 days - Barthel Index (less than 60, including death), Barthel Index more than 95/100 at three months (good outcome), quality of life (EuroQol), abbreviated mental test score 4. Safety measures - death at 7 and 90 days, symptomatic intracranial haemorrhage at 7 days, major extracranial haemorrhage at 10 days

—

Countries

Australia, Canada, China, Denmark, Egypt, Georgia, Greece, Hong Kong, India, Ireland, Italy, Malaysia, New Zealand, Norway, Philippines, Poland, Romania, Singapore, Spain, Sri Lanka, Sweden, Turkey, United Kingdom

Outcome results

None listed