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Effect of hyperacute administration (within 6 hours) of transdermal glyceryl trinitrate, a nitric oxide donor, on outcome after stroke

Woodhouse, Lisa J.; Scutt, Polly; Krishnan, Kailash; Berge, Eivind; Gommans, John; Ntaios, George; Wardlaw, Joanna M.; Sprigg, Nikola; Bath, Philip M.W.

Authors

Kailash Krishnan

Eivind Berge

John Gommans

George Ntaios

Joanna M. Wardlaw

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

Philip M.W. Bath



Abstract

Background and Purpose — Nitric oxide donors are candidate treatments for acute stroke, potentially through hemodynamic, reperfusion, and neuroprotectant effects, especially if given early. Although the large Efficacy of Nitric Oxide in Stroke (ENOS) trial of transdermal glyceryl trinitrate (GTN) was neutral, a prespecified subgroup suggested that GTN improved functional outcome if administered early after stroke onset.

Methods — Prospective analysis of subgroup of patients randomized into the ENOS trial within 6 hours of stroke onset. Safety and efficacy of GTN versus no GTN were assessed using data on early and late outcomes.

Results — Two hundred seventy-three patients were randomized within 6 hours of ictus: mean (SD) age, 69.9 (12.7) years; men, 154 (56.4%); ischemic stroke, 208 (76.2%); Scandinavian Stroke Scale, 32.1 (11.9); and total anterior circulation syndrome, 86 (31.5%). When compared with no GTN, the first dose of GTN lowered blood pressure by 9.4/3.3 mm Hg (P

Journal Article Type Article
Publication Date Oct 13, 2015
Journal Stroke
Print ISSN 0039-2499
Electronic ISSN 1524-4628
Publisher American Heart Association
Peer Reviewed Peer Reviewed
Volume 46
Issue 11
APA6 Citation Woodhouse, L. J., Scutt, P., Krishnan, K., Berge, E., Gommans, J., Ntaios, G., …Bath, P. M. (2015). Effect of hyperacute administration (within 6 hours) of transdermal glyceryl trinitrate, a nitric oxide donor, on outcome after stroke. Stroke, 46(11), doi:10.1161/STROKEAHA.115.009647
DOI https://doi.org/10.1161/STROKEAHA.115.009647
Keywords Blood pressure, Cerebral haemorrhage, Nitroglycerin, Nitric oxide, Stroke
Publisher URL https://doi.org/10.1161/STROKEAHA.115.009647
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
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