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All Outputs (21)

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.

Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial (2021)
Journal Article
the TICH-2 Investigators, Law, Z. K., Appleton, J. P., Scutt, P., Roberts, I., Al-Shahi Salman, R., …Sprigg, N. (2021). Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial. Stroke, 53(4), 1141-1148. https://doi.org/10.1161/STROKEAHA.121.035191

Background: Seeking consent rapidly in acute stroke trials is crucial as interventions are time sensitive. We explored the association between consent pathways and time to enrollment in the TICH-2 (Tranexamic Acid in Intracerebral Haemorrhage-2) rand... Read More about Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial.

Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage (2021)
Journal Article
Pszczolkowski, S., Manzano-Patrón, J. P., Law, Z. K., Krishnan, K., Ali, A., Bath, P. M., …Dineen, R. A. (2021). Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage. European Radiology, 31, 7945-7959. https://doi.org/10.1007/s00330-021-07826-9

Objectives: To test radiomics-based features extracted from noncontrast CT of patients with spontaneous intracerebral haemorrhage for prediction of haematoma expansion and poor functional outcome and compare them with radiological signs and clinical... Read More about Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage.

Outcomes in Antiplatelet?Associated Intracerebral Hemorrhage in the TICH?2 Randomized Controlled Trial (2021)
Journal Article
Law, Z. K., Desborough, M., Roberts, I., Al‐Shahi Salman, R., England, T. J., Werring, D. J., …Sprigg, N. (2021). Outcomes in Antiplatelet‐Associated Intracerebral Hemorrhage in the TICH‐2 Randomized Controlled Trial. Journal of the American Heart Association, 10(5), Article e019130. https://doi.org/10.1161/jaha.120.019130

Background Antiplatelet therapy increases the risk of hematoma expansion in intracerebral hemorrhage (ICH) while the effect on functional outcome is uncertain. Methods and Results This is an exploratory analysis of the TICH‐2 (Tranexamic Acid in... Read More about Outcomes in Antiplatelet?Associated Intracerebral Hemorrhage in the TICH?2 Randomized Controlled Trial.

Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid (2020)
Journal Article
Law, Z. K., England, T. J., Mistri, A. K., Woodhouse, L. J., Cala, L., Dineen, R., …TICH-2 investigators. (2020). Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid. European Stroke Journal, 5(2), 123-129. 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.

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.

Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic stroke: the LACunar Intervention-1 (LACI-1) trial, a randomised clinical trial (2019)
Journal Article
Blair, G. W., Appleton, J. P., Flaherty, K., Doubal, F., Sprigg, N., Dooley, R., …Wardlaw, J. M. (2019). Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic stroke: the LACunar Intervention-1 (LACI-1) trial, a randomised clinical trial. EClinicalMedicine, 11, 34-43. https://doi.org/10.1016/j.eclinm.2019.04.001

Background Lacunar stroke, a frequent clinical manifestation of small vessel disease (SVD), differs pathologically from other ischaemic stroke subtypes and has no specific long-term secondary prevention. Licenced drugs, isosorbide mononitrate (ISMN)... Read More about Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic stroke: the LACunar Intervention-1 (LACI-1) trial, a randomised clinical trial.

Prevention of haematoma progression by tranexamic acid in intracerebral haemorrhage patients with and without spot sign on admission scan: a statistical analysis plan of a pre-specified sub-study of the TICH-2 trial (2018)
Journal Article
Ovesen, C., Jakobsen, J. C., Gluud, C., Steiner, T., Law, Z., Flaherty, K., …Christensen, H. (2018). Prevention of haematoma progression by tranexamic acid in intracerebral haemorrhage patients with and without spot sign on admission scan: a statistical analysis plan of a pre-specified sub-study of the TICH-2 trial. BMC Research Notes, 11, Article 379. https://doi.org/10.1186/s13104-018-3481-8

Objective We present the statistical analysis plan of a prespecified Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage (TICH)-2 sub-study aiming to investigate, if tranexamic acid has a different effect in intracerebral haemorrhage... Read More about Prevention of haematoma progression by tranexamic acid in intracerebral haemorrhage patients with and without spot sign on admission scan: a statistical analysis plan of a pre-specified sub-study of the TICH-2 trial.

Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial (2018)
Conference Proceeding
Appleton, J. P., Flaherty, K., Blair, G. W., Law, Z. K., Doubal, F., Sprigg, N., …Wardlaw, J. M. (2018). Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial.

Background: Cilostazol and isosorbide mononitrate (ISMN) have properties that may be of benefit in the context of cerebral small vessel disease and lacunar ischaemic stroke. As both drugs may influence platelet and haemoglobin levels, we sought to as... Read More about Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial.

Results from the tranexamic acid for primary intracerebral haemorrhage-2 (TICH-2) trial (2018)
Conference Proceeding
Sprigg, N., Flaherty, K., Law, Z. K., Appleton, J. P., Scutt, P., Krishnan, K., & Bath, P. M. (2018). Results from the tranexamic acid for primary intracerebral haemorrhage-2 (TICH-2) trial.

Background: Haematoma expansion leads to worse outcome in intracerebral haemorrhage (ICH). Tranexamic acid (TXA) is a promising haemostatic agent to prevent haematoma expansion and improve outcome after ICH. Methods: TICH-2 is a multicentre prospect... Read More about Results from the tranexamic acid for primary intracerebral haemorrhage-2 (TICH-2) trial.

The effect of transdermal glyceryl trinitrate in acute stroke patients with carotid stenosis: data from the Efficacy of Nitric Oxide in Stroke trial (2018)
Conference Proceeding
Appleton, J., Woodhouse, L., Law, Z., Sprigg, N., & Bath, P. (2018). The effect of transdermal glyceryl trinitrate in acute stroke patients with carotid stenosis: data from the Efficacy of Nitric Oxide in Stroke trial.

Background: There is concern that blood pressure lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the context of carotid stenosis. The effect of glyceryl trinitrate (GTN) on outcome in acute stroke patients with caroti... Read More about The effect of transdermal glyceryl trinitrate in acute stroke patients with carotid stenosis: data from the Efficacy of Nitric Oxide in Stroke trial.

The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 2; peer review: 2 approved] (2018)
Journal Article
Ker, K., Prieto-Merino, D., Sprigg, N., Mahmood, A., Bath, P. M., Kang Law, Z., …Roberts, I. (2018). The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 2; peer review: 2 approved]. Wellcome Open Research, Article 120. https://doi.org/10.12688/wellcomeopenres.13262.2

© 2018 Ker K et al. Introduction: The Antifibrinolytic Trialists Collaboration aims to increase knowledge about the effectiveness and safety of antifibrinolytic treatment by conducting individual patient data (IPD) meta-analyses of randomised trials.... Read More about The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 2; peer review: 2 approved].

Does tranexamic acid lead to changes in MRI-measures of brain tissue health in patients with spontaneous intracerebral haemorrhage? An MRI sub-study nested within the double-blind randomised controlled TICH-2 trial (2018)
Journal Article
Dineen, R. A., Pszczolkowski, S., Flaherty, K., Law, Z. K., Morgan, P. S., Roberts, I., …Sprigg, N. (in press). Does tranexamic acid lead to changes in MRI-measures of brain tissue health in patients with spontaneous intracerebral haemorrhage? An MRI sub-study nested within the double-blind randomised controlled TICH-2 trial. BMJ Open, 8(2), Article e019930. https://doi.org/10.1136/bmjopen-2017-019930

Objectives: To test whether administration of the antifibrinolytic drug tranexamic acid (TXA) in patients with spontaneous intracerebral haemorrhage (SICH) leads to increased prevalence of diffusion-weighted MRI defined hyperintense ischaemic lesions... Read More about Does tranexamic acid lead to changes in MRI-measures of brain tissue health in patients with spontaneous intracerebral haemorrhage? An MRI sub-study nested within the double-blind randomised controlled TICH-2 trial.

Statistical analysis plan for the ‘Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage’ (TICH-2) trial (2017)
Journal Article
Flaherty, K., Bath, P. M., Dineen, R., Law, Z., Scutt, P., Pocock, S., & Sprigg, N. (in press). Statistical analysis plan for the ‘Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage’ (TICH-2) trial. Trials, 18(1), Article 607. https://doi.org/10.1186/s13063-017-2341-5

Rationale Aside from blood pressure lowering, treatment options for intracerebral haemorrhage remain limited and a proportion of patients will undergo early haematoma expansion with resultant significant morbidity and mortality. Tranexamic acid (T... Read More about Statistical analysis plan for the ‘Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage’ (TICH-2) trial.

TICH-2 Trial – Tranexamic Acid for Intracerebral Haemorrhage 2 (2017)
Conference Proceeding
Sprigg, N., Bath, P. M., Appleton, J., Law, Z., Flaherty, K., Scutt, P., …Ali, A. (2017). TICH-2 Trial – Tranexamic Acid for Intracerebral Haemorrhage 2.

Rationale: To assess in a pragmatic phase III prospective double blind randomised placebo-controlled trial whether tranexamic acid is safe and reduces death or dependency after spontaneous intracerebral haemorrhage (SICH). The results will determine... Read More about TICH-2 Trial – Tranexamic Acid for Intracerebral Haemorrhage 2.

Preventing cognitive decline and dementia from cerebral small vessel disease: The LACI-1 Trial. Protocol and statistical analysis plan of a phase IIa dose escalation trial testing tolerability, safety and effect on intermediary endpoints of isosorbide mononitrate and cilostazol, separately and in combination (2017)
Journal Article
Blair, G. W., Appleton, J. P., Law, Z. K., Doubal, F., Flaherty, K., Dooley, R., …Wardlaw, J. M. (2018). Preventing cognitive decline and dementia from cerebral small vessel disease: The LACI-1 Trial. Protocol and statistical analysis plan of a phase IIa dose escalation trial testing tolerability, safety and effect on intermediary endpoints of isosorbide mononitrate and cilostazol, separately and in combination. International Journal of Stroke, 13(5), 530-538. https://doi.org/10.1177/1747493017731947

Rationale The pathophysiology of most lacunar stroke, a form of small vessel disease, is thought to differ from large artery atherothrombo- or cardio-embolic stroke. Licensed drugs, isosorbide mononitrate and cilostazol, have promising mechanisms... Read More about Preventing cognitive decline and dementia from cerebral small vessel disease: The LACI-1 Trial. Protocol and statistical analysis plan of a phase IIa dose escalation trial testing tolerability, safety and effect on intermediary endpoints of isosorbide mononitrate and cilostazol, separately and in combination.

Management of acute intracerebral haemorrhage – an update (2017)
Journal Article
Law, Z. K., Appleton, J. P., Bath, P. M., & Sprigg, N. (2017). Management of acute intracerebral haemorrhage – an update. Clinical Medicine, 17(2), https://doi.org/10.7861/clinmedicine.17-2-166

Managing acute intracerebral haemorrhage is a challenging task for physicians. Evidence shows that outcome can be improved with admission to an acute stroke unit and active care, including urgent reversal of anticoagulant effects and, potentially, in... Read More about Management of acute intracerebral haemorrhage – an update.