All Outputs (266)

The assessment of dysphagia after stroke: state of the art and future directions (2023)
Journal Article
Labeit, B., Michou, E., Hamdy, S., Trapl-Grundschober, M., Suntrup-Krueger, S., Muhle, P., …Dziewas, R. (2023). The assessment of dysphagia after stroke: state of the art and future directions. Lancet Neurology, 22(9), 858-870. https://doi.org/10.1016/S1474-4422%2823%2900153-9

Dysphagia is a major complication following an acute stroke that affects the majority of patients. Clinically, dysphagia after stroke is associated with increased risk of aspiration pneumonia, malnutrition, mortality, and other adverse functional out... Read More about The assessment of dysphagia after stroke: state of the art and future directions.

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., …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.

Blood pressure medication and acute kidney injury after intracerebral haemorrhage: an analysis of the ATACH-II trial (2023)
Journal Article
Naidech, A. M., Wang, H., Hutch, M., Murphy, J., Paparello, J., Bath, P., …Luo, Y. (2023). Blood pressure medication and acute kidney injury after intracerebral haemorrhage: an analysis of the ATACH-II trial. BMJ Neurology Open, 5(2), Article e000458. https://doi.org/10.1136/bmjno-2023-000458

Background: Acute blood pressure (BP) reduction is standard of care after acute intracerebral haemorrhage (ICH). More acute BP reduction is associated with acute kidney injury (AKI). It is not known if the choice of antihypertensive medications affec... Read More about Blood pressure medication and acute kidney injury after intracerebral haemorrhage: an analysis of the ATACH-II trial.

Usability and feasibility of PreventS-MD webapp for stroke prevention (2023)
Journal Article
Feigin, V. L., Krishnamurthi, R., Medvedev, O., Merkin, A., Nair, B., Kravchenko, M., …Feigin, V. L. (2024). Usability and feasibility of PreventS-MD webapp for stroke prevention. International Journal of Stroke, 19(1), 94-104. https://doi.org/10.1177/17474930231190745

Background: Most strokes and cardiovascular diseases (CVDs) are potentially preventable if their risk factors are identified and well controlled. Digital platforms, such as the PreventS-MD webapp (PreventS-MD) may aid health care professionals (HCPs)... Read More about Usability and feasibility of PreventS-MD webapp for stroke prevention.

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., …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.

Optimising the analysis of vascular prevention trials: Re-Assessment of the TARDIS trial, the first prevention trial to adopt an ordinal primary outcome measure (2023)
Journal Article
Woodhouse, L. J., Montgomery, A. A., Pocock, S., James, M., Ranta, A., Bath, P. M., & TARDIS Investigators, T. I. (2023). Optimising the analysis of vascular prevention trials: Re-Assessment of the TARDIS trial, the first prevention trial to adopt an ordinal primary outcome measure. Contemporary Clinical Trials Communications, 35, Article 101186. https://doi.org/10.1016/j.conctc.2023.101186

Background: Ordinalised vascular outcomes incorporating event severity are more informative than binary outcomes that just include event numbers. The TARDIS trial was the first vascular prevention study to use an ordinalised vascular outcome as its p... Read More about Optimising the analysis of vascular prevention trials: Re-Assessment of the TARDIS trial, the first prevention trial to adopt an ordinal primary outcome measure.

A systematic review of ambulance service-based randomised controlled trials in stroke (2023)
Journal Article
Dixon, M., Appleton, J. P., Siriwardena, A. N., Williams, J., & Bath, P. M. (2023). A systematic review of ambulance service-based randomised controlled trials in stroke. Neurological Sciences, 44(12), 4363-4378. https://doi.org/10.1007/s10072-023-06910-w

Background: Treatment for stroke is time-dependent, and ambulance services play a vital role in the early recognition, assessment and transportation of stroke patients. Innovations which begin in ambulance services to expedite delivery of treatments... Read More about A systematic review of ambulance service-based randomised controlled trials in stroke.

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., …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., …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., …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., …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., …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.

Association of CYP2C19 Loss-of-Function Metabolizer Status With Stroke Risk Among Chinese Patients Treated With Ticagrelor-Aspirin vs Clopidogrel-Aspirin: A Prespecified Secondary Analysis of a Randomized Clinical Trial. (2023)
Journal Article
Xie, X., Johnston, S. C., Wang, A., Xu, Q., Bath, P. M., Pan, Y., …Wang, Y. (2023). Association of CYP2C19 Loss-of-Function Metabolizer Status With Stroke Risk Among Chinese Patients Treated With Ticagrelor-Aspirin vs Clopidogrel-Aspirin: A Prespecified Secondary Analysis of a Randomized Clinical Trial. JAMA Network Open, 6(6), Article e2317037. https://doi.org/10.1001/jamanetworkopen.2023.17037

Importance: The Clopidogrel With Aspirin in High-Risk Patients With Acute Nondisabling Cerebrovascular Events II (CHANCE-2) trial showed that ticagrelor-aspirin combination therapy reduced the risk of stroke compared with a clopidogrel-aspirin combi... Read More about Association of CYP2C19 Loss-of-Function Metabolizer Status With Stroke Risk Among Chinese Patients Treated With Ticagrelor-Aspirin vs Clopidogrel-Aspirin: A Prespecified Secondary Analysis of a Randomized Clinical Trial..

Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease: The Lacunar Intervention Trial-2 (LACI-2) Randomized Clinical Trial (2023)
Journal Article
Wardlaw, J. M., Woodhouse, L. J., Mhlanga, I. I., Oatey, K., Heye, A. K., Bamford, J., …Bath, P. M. (2023). Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease: The Lacunar Intervention Trial-2 (LACI-2) Randomized Clinical Trial. JAMA Neurology, 80(7), 682-692. https://doi.org/10.1001/jamaneurol.2023.1526

Importance Cerebral small vessel disease (cSVD) is a common cause of stroke (lacunar stroke), is the most common cause of vascular cognitive impairment, and impairs mobility and mood but has no specific treatment.

Objective To test the feasibili... Read More about Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease: The Lacunar Intervention Trial-2 (LACI-2) Randomized Clinical Trial.

Accuracy of artificial intelligence software for CT angiography in stroke (2023)
Journal Article
Mair, G., White, P., Bath, P. M., Muir, K., Martin, C., Dye, D., …for the RITeS Collaboration. (2023). Accuracy of artificial intelligence software for CT angiography in stroke. Annals of Clinical and Translational Neurology, 10(7), 1072-1082. https://doi.org/10.1002/acn3.51790

Objective: Software developed using artificial intelligence may automatically identify arterial occlusion and provide collateral vessel scoring on CT angiography (CTA) performed acutely for ischemic stroke. We aimed to assess the diagnostic accuracy... Read More about Accuracy of artificial intelligence software for CT angiography in stroke.

Evaluation of Endothelial Progenitor Cell Characteristics as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke (2023)
Journal Article
Rakkar, K., Othman, O. A., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2023). Evaluation of Endothelial Progenitor Cell Characteristics as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke. Stem Cell Reviews and Reports, 19(6), 1856-1869. https://doi.org/10.1007/s12015-023-10544-y

Ageing impairs endothelial function and predisposes the person to ischaemic stroke (IS). Endothelial progenitor cells (EPCs) repair endothelial damage and induce post-ischaemic neovascularisation. Given the prevalence of IS in older population, this... Read More about Evaluation of Endothelial Progenitor Cell Characteristics as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke.

Indobufen versus aspirin in patients with acute ischaemic stroke in China (INSURE): a randomised, double-blind, double-dummy, active control, non-inferiority trial (2023)
Journal Article
Pan, Y., Meng, X., Yuan, B., Johnston, S. C., Li, H., Bath, P. M., …Wang, Y. (2023). Indobufen versus aspirin in patients with acute ischaemic stroke in China (INSURE): a randomised, double-blind, double-dummy, active control, non-inferiority trial. Lancet Neurology, 22(6), 485-493. https://doi.org/10.1016/s1474-4422%2823%2900113-8

Background
Aspirin is recommended for secondary stroke prevention in patients with moderate-to-severe ischaemic stroke but can lead to gastrointestinal intolerance and bleeding. Indobufen is used as an alternative antiplatelet agent in some countrie... Read More about Indobufen versus aspirin in patients with acute ischaemic stroke in China (INSURE): a randomised, double-blind, double-dummy, active control, non-inferiority trial.

Effects of intensive blood pressure lowering on cerebral ischaemia in thrombolysed patients: insights from the ENCHANTED trial (2023)
Journal Article
Chen, C., Ouyang, M., Ong, S., Zhang, L., Zhang, G., Delcourt, C., …ENCHANTED investigators. (2023). Effects of intensive blood pressure lowering on cerebral ischaemia in thrombolysed patients: insights from the ENCHANTED trial. eClinicalMedicine, 57, Article 101849. https://doi.org/10.1016/j.eclinm.2023.101849

Background: Intensive blood pressure lowering may adversely affect evolving cerebral ischaemia. We aimed to determine whether intensive blood pressure lowering altered the size of cerebral infarction in the 2196 patients who participated in the Enhan... Read More about Effects of intensive blood pressure lowering on cerebral ischaemia in thrombolysed patients: insights from the ENCHANTED trial.

Rationale and Design of a randomized double-blind 2 × 2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis (INSPIRES) (2023)
Journal Article
Gao, Y., Pan, Y., Han, S., Chen, W., Jing, J., Wang, C., …Wang, Y. (2023). Rationale and Design of a randomized double-blind 2 × 2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis (INSPIRES). Stroke and Vascular Neurology, 8(3), Article e002084. https://doi.org/10.1136/svn-2022-002084

Background: It remains unclear if intensive antiplatelet and statin treatments begun within 24–72 hours of cerebral ischaemic events from intracranial or extracranial atherosclerosis is effective or safe.
Methods: The Intensive Statin and Antiplatel... Read More about Rationale and Design of a randomized double-blind 2 × 2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis (INSPIRES).

Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack (2023)
Journal Article
Krishnan, K., Nguyen, T. N., Appleton, J. P., Law, Z. K., Caulfied, M., Cabrera, C. P., …Bath, P. M. (2023). Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack. Stroke: Vascular and Interventional Neurology, 3(3), Article e000576. https://doi.org/10.1161/svin.122.000576

Acute ischemic stroke is a leading cause of death and major disability worldwide. Approximately 50% of ischemic strokes are caused by atherothrombotic occlusion of the cerebral arteries, and antiplatelets are the mainstay of secondary stroke preventa... Read More about Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack.