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Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid (2020)
Journal Article
Woodhouse, L. J., Mistri, A. K., Bath, P. M., Law, Z. K., England, T. J., Mistri, A. K., …TICH-2 investigators, . (2020). Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid. European Stroke Journal, https://doi.org/10.1177/2396987320901391

Introduction Seizures are common after intracerebral haemorrhage. Tranexamic acid increases the risk of seizures in non-intracerebral haemorrhage population but its effect on post-intracerebral haemorrhage seizures is unknown. We explored the risk f... Read More about Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid.

Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage (2019)
Journal Article
Law, Z. K., Ali, A., Krishnan, K., Bischoff, A., Appleton, J., Scutt, P., …Sprigg, N. (2020). Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage. Stroke, 51(1), 121–128. https://doi.org/10.1161/STROKEAHA.119.026128

Background and purpose Blend, black hole and island signs and hypodensities are reported to predict hematoma expansion in acute intracerebral hemorrhage (ICH). We explored the value of these noncontrast CT (NCCT) signs in predicting hematoma expan... Read More about Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage.

Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage (2019)
Journal Article
Bath, P. M., Woodhouse, L. J., Krishnan, K., Appleton, J. P., Anderson, C. S., Berge, E., …Sprigg, N. (2019). Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage. Stroke, 50(11), https://doi.org/10.1161/STROKEAHA.119.026389

Background and Purpose— Pilot trials suggest that glyceryl trinitrate (GTN; nitroglycerin) may improve outcome when administered early after stroke onset. Methods— We undertook a multicentre, paramedic-delivered, ambulance-based, prospective ran... Read More about Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage.

Effects of Isosorbide Mononitrate and/or Cilostazol on Hematological Markers, Platelet Function, and Hemodynamics in Patients With Lacunar Ischaemic Stroke: Safety Data From the Lacunar Intervention-1 (LACI-1) Trial (2019)
Journal Article
Appleton, J., Blair, G. W., Flaherty, K., Law, Z., May, J., Woodhouse, L. J., …Wardlow, J. M. (2019). Effects of Isosorbide Mononitrate and/or Cilostazol on Hematological Markers, Platelet Function, and Hemodynamics in Patients With Lacunar Ischaemic Stroke: Safety Data From the Lacunar Intervention-1 (LACI-1) Trial. Frontiers in Neurology, 10, 1-6. https://doi.org/10.3389/fneur.2019.00723

Background Cilostazol and isosorbide mononitrate (ISMN) are candidate treatments for cerebral small vessel disease and lacunar ischaemic stroke. As both drugs may influence haemoglobin and platelet count, and haemodynamics, we sought to assess their... Read More about Effects of Isosorbide Mononitrate and/or Cilostazol on Hematological Markers, Platelet Function, and Hemodynamics in Patients With Lacunar Ischaemic Stroke: Safety Data From the Lacunar Intervention-1 (LACI-1) Trial.

Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT (2019)
Journal Article
Sprigg, N., Flaherty, K., Appleton, J. P., Al-Shahi Salman, R., Bereczki, D., Beridze, M., …Bath, P. M. (2019). Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT. Health Technology Assessment, 23(35), 1-48. doi:10.3310/hta23350

Background Tranexamic acid reduces death due to bleeding after trauma and postpartum haemorrhage. Objective The aim of the study was to assess if tranexamic acid is safe, reduces haematoma expansion and improves outcomes in adults with spontaneo... Read More about Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT.

Associations between change in blood pressure and functional outcome, early events and death: results from the Efficacy of Nitric Oxide in Stroke trial (2019)
Journal Article
Sandset, E. C., Appleton, J. P., Berge, E., Christensen, H., Gommans, J., Krishnan, K., …Bath, P. M. (2019). Associations between change in blood pressure and functional outcome, early events and death: results from the Efficacy of Nitric Oxide in Stroke trial. Journal of Hypertension, 37(10), 2104-2109. doi:10.1097/HJH.0000000000002154

Objectives: High blood pressure (BP) is associated with a poor outcome after acute stroke. Early reduction in blood pressure (BP) may be associated with fewer early adverse events and deaths, and improved functional outcome. Methods: Analyses used d... Read More about Associations between change in blood pressure and functional outcome, early events and death: results from the Efficacy of Nitric Oxide in Stroke trial.

It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis (2019)
Journal Article
Appleton, J. P., Woodhouse, L. J., Belcher, A., Bereczki, D., Berge, E., Caso, V., …Bath, P. M. (2019). It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis. Stroke and Vascular Neurology, 4(1), 1-35. doi:10.1136/svn-2019-000232

Background: There is concern that blood pressure (BP) lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis. We assessed the effect of glyceryl trinitrate (GTN) in patients with carotid sten... Read More about It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis.

It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis (2019)
Journal Article
Appleton, J. P., Woodhouse, L. J., Belcher, A., Bereczki, D., Berge, E., Caso, V., …Bath, P. M. (2019). It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis. Stroke and Vascular Neurology, 4(1), 28-35. doi:10.1136/svn-2019-000232

Background There is concern that blood pressure (BP) lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis. We assessed the effect of glyceryl trinitrate (GTN) in patients with carotid steno... Read More about It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis.

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial (2019)
Journal Article
Bath, P. M., Scutt, P., Anderson, C. S., Ankolekar, S., Appleton, J. P., Berge, E., …Sprigg, N. (2019). Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial. Lancet, 393(10175), 1009-1020. doi:10.1016/S0140-6736(19)30194-1

Background High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains uncle... Read More about Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial.

Effect of glyceryl trinitrate on haemodynamics in acute stroke: data from the Efficacy of Nitric Oxide in Stroke trial (2019)
Journal Article
Appleton, J. P., Woodhouse, L. J., Bereczki, D., Berge, E., Christensen, H. K., Collins, R., …ENOS Investigators, . (2019). Effect of glyceryl trinitrate on haemodynamics in acute stroke: data from the Efficacy of Nitric Oxide in Stroke trial. Stroke, 50(2), doi:10.1161/STROKEAHA.118.023190

Background and Purpose: Increased blood pressure (BP), heart rate and their derivatives (variability, pulse pressure, rate-pressure product [RPP]) are associated with poor clinical outcome in acute stroke. We assessed the effects of glyceryl trinitra... Read More about Effect of glyceryl trinitrate on haemodynamics in acute stroke: data from the Efficacy of Nitric Oxide in Stroke trial.

Central adjudication of serious events did not affect trial's safety results: data from the Efficacy of Nitric Acid in Stroke (ENOS trial) (2018)
Journal Article
Godolphin, P., Montgomery, A., Woodhouse, L., Bereczki, D., Berge, E., Collins, R., …ENOS Investigators, . (2018). Central adjudication of serious events did not affect trial's safety results: data from the Efficacy of Nitric Acid in Stroke (ENOS trial). PLoS ONE, 13(11), doi:10.1371/journal.pone.0208142

Background and Purpose: Central adjudication of serious adverse events (SAEs) can be undertaken in clinical trials, especially for open-label studies where outcome assessment may be at risk of bias. This study explored the effect of central adjudicat... Read More about Central adjudication of serious events did not affect trial's safety results: data from the Efficacy of Nitric Acid in Stroke (ENOS trial).

Baseline characteristics of the 1149 patients recruited into the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) randomized controlled trial (2018)
Journal Article
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

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

Impact of ultra/hyper-acute administration of glyceryl trinitrate on secondary outcome after acute stroke: a meta-analysis of individual patient data from randomised trials (2018)
Conference Proceeding
Bath, P. M., Woodhouse, L. J., & Sprigg, N. (2018). Impact of ultra/hyper-acute administration of glyceryl trinitrate on secondary outcome after acute stroke: a meta-analysis of individual patient data from randomised trials

Background Glyceryl trinitrate (GTN) is a candidate reperfusion and hypotensive treatment for hyperacute stroke. We assessed the effect of early administration of GTN (within 6 hours) on secondary outcomes (taken at 3 months post randomisation), acro... Read More about Impact of ultra/hyper-acute administration of glyceryl trinitrate on secondary outcome after acute stroke: a meta-analysis of individual patient data from randomised trials.

Baseline predictors of on-treatment platelet activity (as P-selectin expression) in patients in the triple aniplatelets for reducing dependency in ischaemic stroke (TARDIS) trial (2018)
Conference Proceeding
Bath, P. M., Woodhouse, L. J., Dovlatova, N., May, J., & Heptinstall, S. (2018). Baseline predictors of on-treatment platelet activity (as P-selectin expression) in patients in the triple aniplatelets for reducing dependency in ischaemic stroke (TARDIS) trial

Background: Platelet activity may be measured remotely as surface P-selectin expression. Predictors of on-treatment P-selectin expression were assessed using baseline characteristics in the TARDIS trial. Methods: TARDIS assessed intensive (combined... Read More about Baseline predictors of on-treatment platelet activity (as P-selectin expression) in patients in the triple aniplatelets for reducing dependency in ischaemic stroke (TARDIS) trial.

Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: the TARDIS RCT (2018)
Journal Article
Bath, P. M., Woodhouse, L. J., Appleton, J. P., Beridze, M., Christensen, H., Dineen, R. A., …Sprigg, N. (2018). Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: the TARDIS RCT. Health Technology Assessment, 22(48), 1-76. doi:10.3310/hta22480

Background: Two antiplatelet agents are better than one for preventing recurrent stroke after acute ischaemic stroke or transient ischaemic attack (TIA). Therefore, intensive treatment with three agents might be better still, providing it does not ca... Read More about Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: the TARDIS RCT.

Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) (2018)
Conference Proceeding
Scutt, P., Dixon, M., Appleton, J. P., Howard, H., Havard, D., Woodhouse, L. J., & Bath, P. M. (2018). Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2)

Background: Obtaining consent in emergency situations is challenging. Proxy consent allows patients to be recruited when they lack capacity, a common scenario in stroke patients. The rapid intervention with glyceryl trinitrate in hypertensive stroke... Read More about Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2).