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Baseline characteristics of the 1149 patients recruited into the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) randomized controlled trial

Bath, Philip M; Scutt, Polly; Appleton, Jason P.; Dixon, Mark; Woodhouse, Lisa J; Wardlaw, Joanna M.; Sprigg, Nikola

Authors

PHILIP BATH philip.bath@nottingham.ac.uk
Stroke Association Professor of Stroke Medicine

Jason P. Appleton

Mark Dixon M.Dixon@nottingham.ac.uk .

Joanna M. Wardlaw

NIKOLA SPRIGG nikola.sprigg@nottingham.ac.uk
Professor of Stroke Medicine



Abstract

Background: High blood pressure (BP) is common in acute stroke and associated with a worse functional outcome. Glyceryl trinitrate (GTN), a nitric oxide donor, lowers BP in acute stroke and may improve outcome.
Aims: RIGHT-2 tested the feasibility of performing a UK multicentre ambulance-based stroke trial, and the safety and efficacy of GTN when administered by paramedics before hospital admission.
Methods: Paramedic-led ambulance-based multi-centre prospective randomised single-blind blinded-endpoint parallel-group controlled trial of transdermal GTN (given for 4 days) versus sham in patients with ultra-acute (less than 4 hours) presumed stroke. Data are number (%), median [interquartile range] or mean (standard deviation).
Results: Recruitment ran from October 2015 to 31st May 2018. 1,149 patients were recruited from 8 UK Ambulance Services and taken to 54 acute hospitals. Baseline characteristics include: mean age 73 (15) years; female 555 (48%); median time from stroke to randomisation 70 [45, 115] minutes; Face-Arm-Speech scale score 2.6 (0.5); and blood pressure 162 (25)/92 (18) mmHg. The final diagnosis was ischaemic stroke 52%, haemorrhagic stroke 13%, TIA 9%, and mimic 25%. The main trial results will be presented in quarter 4 2018. The results will also be included in updated Cochrane systematic reviews, and individual patient data meta-analyses of all relevant randomised controlled trials.
Conclusion: It was feasible to perform a multicentre ambulance-based ultra-acute stroke trial in the UK, and to treat with GTN versus sham. The relatively unselected cohort of stroke patients is broadly representative of those admitted to hospital in the UK.

Journal Article Type Article
Publication Date Nov 26, 2018
Journal International Journal of Stroke
Print ISSN 1747-4930
Electronic ISSN 1747-4949
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 14
Issue 3
Pages 298-305
APA6 Citation Wardlaw, J. M., Appleton, J. P., Bath, P. M., Scutt, P., Appleton, J. P., Dixon, M., …Sprigg, N. (2018). Baseline characteristics of the 1149 patients recruited into the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) randomized controlled trial. International Journal of Stroke, 14(3), 298-305. https://doi.org/10.1177/1747493018816451
DOI https://doi.org/10.1177/1747493018816451
Keywords Neurology
Publisher URL https://journals.sagepub.com/eprint/92TSIisThWs35FvFvmNc/full

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