Professor NIKOLA SPRIGG's Outputs (171)

Optimal timing of anticoagulation after acute ischaemic stroke with atrial fibrillation (OPTIMAS): a multicentre, blinded-endpoint, phase 4, randomised controlled trial (2024)
Journal Article
Werring, D. J., Dehbi, H. M., Ahmed, N., Arram, L., Best, J. G., Balogun, M., Bennett, K., Bordea, E., Caverly, E., Chau, M., Cohen, H., Cullen, M., Doré, C. J., Engelter, S. T., Fenner, R., Ford, G. A., Gill, A., Hunter, R., James, M., Jayanthi, A., …Freemantle, N. (2024). Optimal timing of anticoagulation after acute ischaemic stroke with atrial fibrillation (OPTIMAS): a multicentre, blinded-endpoint, phase 4, randomised controlled trial. Lancet, 404(10464), 1731-1741. https://doi.org/10.1016/S0140-6736%2824%2902197-4

Background: The optimal timing of anticoagulation for patients with acute ischaemic stoke with atrial fibrillation is uncertain. We investigated the efficacy and safety of early compared with delayed initiation of direct oral anticoagulants (DOACs) i... Read More about Optimal timing of anticoagulation after acute ischaemic stroke with atrial fibrillation (OPTIMAS): a multicentre, blinded-endpoint, phase 4, randomised controlled trial.

Tenecteplase versus alteplase for acute stroke within 4·5 h of onset (ATTEST-2): a randomised, parallel group, open-label trial (2024)
Journal Article
Muir, K. W., Ford, G. A., Ford, I., Wardlaw, J. M., McConnachie, A., Greenlaw, N., Mair, G., Sprigg, N., Price, C. I., MacLeod, M. J., Dima, S., Venter, M., Zhang, L., O'Brien, E., Sanyal, R., Reid, J., Sztriha, L. K., Haider, S., Whiteley, W. N., Kennedy, J., …Douglass, C. (2024). Tenecteplase versus alteplase for acute stroke within 4·5 h of onset (ATTEST-2): a randomised, parallel group, open-label trial. Lancet Neurology, 23(11), 1087-1096. https://doi.org/10.1016/S1474-4422%2824%2900377-6

Background: Tenecteplase has potential benefits over alteplase, the standard agent for intravenous thrombolysis in acute ischaemic stroke, because it is administered as a single bolus and might have superior efficacy. The ATTEST-2 trial investigated... Read More about Tenecteplase versus alteplase for acute stroke within 4·5 h of onset (ATTEST-2): a randomised, parallel group, open-label trial.

Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial (2024)
Journal Article
Appleton, J. P., Dixon, M., Woodhouse, L. J., Anderson, C. S., Ankolekar, S., Cala, L., England, T. J., Godolphin, P. J., Krishnan, K., Mair, G., Muir, K. W., Potter, J., Price, C. I., Randall, M., Robinson, T. G., Roffe, C., Rothwell, P. M., Sandset, E. C., Saver, J. L., Siriwardena, A. N., …Bath, P. M. (2024). Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial. European Journal of Neurology, 31(12), Article e16502. https://doi.org/10.1111/ene.16502

Background and purpose
Ambulance trials assessing interventions in suspected stroke patients will recruit patients with currently active symptoms that will resolve into transient ischaemic attack (TIA). The safety and efficacy of glyceryl trinitrate... Read More about Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial.

Comorbidities and Angiogenic Regulators Affect Endothelial Progenitor Cell Subtype Numbers in a Healthy Volunteer Control Group (2024)
Journal Article
Rakkar, K., Kadir, R. R. A., Othman, O. A., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2024). Comorbidities and Angiogenic Regulators Affect Endothelial Progenitor Cell Subtype Numbers in a Healthy Volunteer Control Group. Stem Cell Reviews and Reports, 20, 2336–2344. https://doi.org/10.1007/s12015-024-10777-5

Endothelial progenitor cells (EPCs) are stem cells that can repair injured blood vessels through neovascularisation. This is achieved through secretion of growth factors and endothelial maturation. EPC numbers and function have been studied to determ... Read More about Comorbidities and Angiogenic Regulators Affect Endothelial Progenitor Cell Subtype Numbers in a Healthy Volunteer Control Group.

Human rights considerations are key when choosing a conference location (2024)
Journal Article
Coutts, S. B., & Sprigg, N. (2024). Human rights considerations are key when choosing a conference location. Lancet, 404(10454), 745. https://doi.org/10.1016/S0140-6736%2824%2901503-4

Outcome 1 year after ICH: Data from the Tranexamic acid for IntraCerebral Haemorrhage 2 (TICH-2) trial (2024)
Journal Article
Law, Z. K., Menon, C. S., Woodhouse, L. J., Appleton, J. P., Al-Shahi Salman, R., Robinson, T., Werring, D., Roffe, C., Dineen, R. A., Bath, P. M., & Sprigg, N. (2024). Outcome 1 year after ICH: Data from the Tranexamic acid for IntraCerebral Haemorrhage 2 (TICH-2) trial. European Stroke Journal, https://doi.org/10.1177/23969873241265939

Introduction:
The Tranexamic acid for IntraCerebral Haemorrhage-2 (TICH-2) trial reported no significant improvement in death and dependency at day 90 despite reductions in haematoma expansion, early neurological deterioration and early death. Howev... Read More about Outcome 1 year after ICH: Data from the Tranexamic acid for IntraCerebral Haemorrhage 2 (TICH-2) trial.

The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial (2024)
Journal Article
Hollingworth, M., Woodhouse, L. J., Law, Z. K., Ali, A., Krishnan, K., Dineen, R. A., Christensen, H., England, T. J., Roffe, C., Werring, D., Peters, N., Ciccone, A., Robinson, T., Członkowska, A., Bereczki, D., Egea-Guerrero, J. J., Ozturk, S., Bath, P. M., & Sprigg, N. (2024). The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial. Neurosurgery, 95(3), 605-616. https://doi.org/10.1227/neu.0000000000002961

BACKGROUND AND OBJECTIVES:
An important proportion of patients with spontaneous intracerebral hemorrhage (ICH) undergo neurosurgical intervention to reduce mass effect from large hematomas and control the complications of bleeding, including hemato... Read More about The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial.

Influence of Time to Achieve Target Systolic Blood Pressure on Outcome After Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration (2024)
Journal Article
Wang, X., Yang, J., Moullaali, T. J., Sandset, E. C., Woodhouse, L. J., Law, Z. K., Arima, H., Butcher, K. S., Delcourt, C., Mbbs, L. E., Gupta, S., Jiang, W., Koch, S., Potter, J., Qureshi, A. I., Robinson, T. G., Salman, R. A.-S., Saver, J. L., Sprigg, N., Wardlaw, J., …Chalmers, J. (2024). Influence of Time to Achieve Target Systolic Blood Pressure on Outcome After Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration. Stroke, 55(4), 849-855. https://doi.org/10.1161/STROKEAHA.123.044358

OBJECTIVE:
To investigate whether an earlier time to achieving and maintaining systolic blood pressure (SBP) at 120 to 140 mm Hg is associated with favorable outcomes in a cohort of patients with acute intracerebral hemorrhage.

METHODS:
We poole... Read More about Influence of Time to Achieve Target Systolic Blood Pressure on Outcome After Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration.

Influence of Time to Achieve Target Systolic Blood Pressure on Outcome after Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration (2024)
Presentation / Conference Contribution
Wang, X., Yang, J., Moullaali, T. J., Sandset, E. C., Woodhouse, L. J., Law, Z. K., Arima, H., Butcher, K. S., Delcourt, C., Edwards, L., Gupta, S., Jiang, W., Koch, S., Potter, J., Qureshi, A. I., Robinson, T. G., Al-Shahi Salman, R., Saver, J. L., Sprigg, N., Wardlaw, J., …Chalmers, J. (2023, May). Influence of Time to Achieve Target Systolic Blood Pressure on Outcome after Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration. Presented at European Stroke Organisation Conference, Munich

OBJECTIVE:
To investigate whether an earlier time to achieving and maintaining systolic blood pressure (SBP) at 120 to 140 mmHg is associated with favorable outcomes in a cohort of patients with acute intracerebral hemorrhage.

METHODS:
We poo... Read More about Influence of Time to Achieve Target Systolic Blood Pressure on Outcome after Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration.

Analysis of Endothelial Progenitor Cell Subtypes as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke (2023)
Journal Article
ABDULKADIR, R., RAKKAR, K., OTHMAN, O., SPRIGG, N., BATH, P., & BAYRAKTUTAN, U. (2023). Analysis of Endothelial Progenitor Cell Subtypes as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke. Scientific Reports, 13, Article 21843. https://doi.org/10.1038/s41598-023-48907-7

Endothelial progenitor cells (EPCs), expressing markers for stemness (CD34), immaturity (CD133) and endothelial maturity (KDR), may determine the extent of post-stroke vascular repair. Given the prevalence of stroke in elderly, this study explored wh... Read More about Analysis of Endothelial Progenitor Cell Subtypes as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke.

Analysis of endothelial progenitor cell subtypes as clinical biomarkers for elderly patients with ischaemic stroke (2023)
Journal Article
Kadir, R. R. A., Rakkar, K., Othman, O. A., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2023). Analysis of endothelial progenitor cell subtypes as clinical biomarkers for elderly patients with ischaemic stroke. Scientific Reports, 13(1), Article 21843. https://doi.org/10.1038/s41598-023-48907-7

Endothelial progenitor cells (EPCs), expressing markers for stemness (CD34), immaturity (CD133) and endothelial maturity (KDR), may determine the extent of post-stroke vascular repair. Given the prevalence of stroke in elderly, this study explored wh... Read More about Analysis of endothelial progenitor cell subtypes as clinical biomarkers for elderly patients with ischaemic stroke.

Evaluating artificial intelligence software for delineating hemorrhage extent on CT brain imaging in stroke: AI delineation of ICH on CT. (2023)
Journal Article
Vacek, A., Mair, G., White, P., Bath, P. M., Muir, K. W., Al-Shahi Salman, R., Martin, C., Dye, D., Chappell, F. M., von Kummer, R., Macleod, M., Sprigg, N., & Wardlaw, J. M. (2024). Evaluating artificial intelligence software for delineating hemorrhage extent on CT brain imaging in stroke: AI delineation of ICH on CT. Journal of Stroke and Cerebrovascular Diseases, 33(1), Article 107512. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107512

Background: : The extent and distribution of intracranial hemorrhage (ICH) directly affects clinical management. Artificial intelligence (AI) software can detect and may delineate ICH extent on brain CT. We evaluated e-ASPECTS software (Brainomix Ltd... Read More about Evaluating artificial intelligence software for delineating hemorrhage extent on CT brain imaging in stroke: AI delineation of ICH on CT..

Haemostatic therapies for stroke due to acute, spontaneous intracerebral haemorrhage (2023)
Journal Article
Eilertsen, H., Menon, C. S., Law, Z. K., Chen, C., Bath, P. M., Steiner, T., Desborough, M. J., Sandset, E. C., Sprigg, N., & Al-Shahi Salman, R. (2023). Haemostatic therapies for stroke due to acute, spontaneous intracerebral haemorrhage. Cochrane Database of Systematic Reviews, 2023(10), Article CD005951.pub5. https://doi.org/10.1002/14651858.CD005951.pub5

Background
Outcome after acute spontaneous (non‐traumatic) intracerebral haemorrhage (ICH) is influenced by haematoma volume. ICH expansion occurs in about 20% of people with acute ICH. Early haemostatic therapy might improve outcome by limiting ICH... Read More about Haemostatic therapies for stroke due to acute, spontaneous intracerebral haemorrhage.

Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials (2023)
Journal Article
Krishnan, K., Campos, P. B., Nguyen, T. N., Tan, C. W., Chan, S. L., Appleton, J. P., Law, Z., Hollingworth, M., Kirkman, M. A., England, T. J., Roffe, C., Macleod, M. J., Dawson, J., Bayraktutan, U., Werring, D. J., Sprigg, N., & Bath, P. M. (2023). Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials. Frontiers in Stroke, 2, Article 1256664. https://doi.org/10.3389/fstro.2023.1256664

Acute intracerebral hemorrhage is the most devastating stroke subtype and is associated with significant morbidity and mortality. Poor prognosis is associated with primary brain injury from the presenting hematoma, and despite advances in clinical tr... Read More about Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials.

Bleeding with intensive versus guideline antiplatelet therapy in acute cerebral ischaemia (2023)
Journal Article
Woodhouse, L. J., Appleton, J. P., Christensen, H., Dineen, R. A., England, T. J., James, M., Krishnan, K., Montgomery, A. A., Ranta, A., Robinson, T. G., Sprigg, N., & Bath, P. M. (2023). Bleeding with intensive versus guideline antiplatelet therapy in acute cerebral ischaemia. Scientific Reports, 13, Article 11717. https://doi.org/10.1038/s41598-023-38474-2

Intensive antiplatelet therapy did not reduce recurrent stroke/transient ischaemic attack (TIA) events as compared with guideline treatment in the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial, but did increase th... Read More about Bleeding with intensive versus guideline antiplatelet therapy in acute cerebral ischaemia.

Surgery for Malignant Acute Ischemic Stroke: A Narrative Review of the Knowns and Unknowns (2023)
Journal Article
Krishnan, K., Hollingworth, M., Nguyen, T. N., Kumaria, A., Kirkman, M. A., Basu, S., Tolias, C., Bath, P. M., & Sprigg, N. (2023). Surgery for Malignant Acute Ischemic Stroke: A Narrative Review of the Knowns and Unknowns. Seminars in Neurology, 43(3), 370-387. https://doi.org/10.1055/s-0043-1771208

Malignant acute ischemic stroke (AIS) is characterized by acute neurological deterioration caused by progressive space-occupying brain edema, often occurring in the first hours to days after symptom onset. Without any treatment, the result is often f... Read More about Surgery for Malignant Acute Ischemic Stroke: A Narrative Review of the Knowns and Unknowns.

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial (2023)
Journal Article
Woodhouse, L. J., Appleton, J. P., Ankolekar, S., England, T. J., Mair, G., Muir, K., Price, C. I., Pocock, S., Randall, M., Robinson, T. G., Roffe, C., Sandset, E. C., Saver, J. L., Siriwardena, A. N., Sprigg, N., Wardlaw, J. M., & Bath, P. M. (2023). Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial. BMJ Neurology Open, 5(1), Article e000424. https://doi.org/10.1136/bmjno-2023-000424

Background The Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2) reported no overall treatment difference between glyceryl trinitrate (GTN) and sham at day 90. Here we assess participants' outcomes 1 year after rand... Read More about Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial.

Desmopressin for patients with spontaneous intracerebral haemorrhage taking antiplatelet drugs (DASH): a UK-based, phase 2, randomised, placebo-controlled, multicentre feasibility trial (2023)
Journal Article
Desborough, M. J. R., Al-Shahi Salman, R., Stanworth, S. J., Havard, D., Woodhouse, L. J., Craig, J., Krishnan, K., Brennan, P. M., Dineen, R. A., Coats, T. J., Hepburn, T., Bath, P. M., Sprigg, N., & for DASH trial investigators, F. D. T. I. (2023). Desmopressin for patients with spontaneous intracerebral haemorrhage taking antiplatelet drugs (DASH): a UK-based, phase 2, randomised, placebo-controlled, multicentre feasibility trial. Lancet Neurology, 22(7), 557-567. https://doi.org/10.1016/S1474-4422%2823%2900157-6

Background: The risk of death from spontaneous intracerebral haemorrhage is increased for people taking antiplatelet drugs. We aimed to assess the feasibility of randomising patients on antiplatelet drug therapy with spontaneous intracerebral haemorr... Read More about Desmopressin for patients with spontaneous intracerebral haemorrhage taking antiplatelet drugs (DASH): a UK-based, phase 2, randomised, placebo-controlled, multicentre feasibility trial.

Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: A secondary analysis of a large randomised controlled trial (2023)
Journal Article
Appleton, J. P., Kang, Z., Woodhouse, L. J., Al-Shahi Salman, R., Beridze, M., Christensen, H., Dineen, R. A., Egea-Guerrero, J. J., England, T. J., Karlinski, M., Krishnan, K., Laska, A. C., Lyrer, P. A., Ozturk, S., Roffe, C., Roberts, I., Robinson, T. G., Scutt, P., Werring, D. J., Bath, P. M., & Sprigg, N. (2023). Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: A secondary analysis of a large randomised controlled trial. BMJ Neurology Open, 5(1), Article e000423. https://doi.org/10.1136/bmjno-2023-000423

Background Tranexamic acid reduced haematoma expansion and early death, but did not improve functional outcome in the tranexamic acid for hyperacute spontaneous intracerebral haemorrhage-2 (TICH-2) trial. In a predefined subgroup, there was a statist... Read More about Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: A secondary analysis of a large randomised controlled trial.

Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial (2023)
Journal Article
Appleton, J. P., Woodhouse, L. J., Anderson, C. S., Ankolekar, S., Cala, L., Dixon, M., England, T. J., Krishnan, K., Mair, G., Muir, K. W., Potter, J., Price, C. I., Randall, M., Robinson, T. G., Roffe, C., Sandset, E. C., Saver, J. L., Shone, A., Siriwardena, A. N., Wardlaw, J. M., …Bath, P. M. (2023). Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial. Stroke and Vascular Neurology, 9(1), https://doi.org/10.1136/svn-2022-001634

Background The effect of transdermal glyceryl trinitrate (GTN, a nitrovasodilator) on clinical outcome when administered before hospital admission in suspected stroke patients is unclear. Here, we assess the safety and efficacy of GTN in the prespeci... Read More about Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial.