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Dysphagia after stroke: research advances in treatment interventions (2024)
Journal Article
Labeit, B., Michou, E., Trapl-Grundschober, M., Suntrup-Krueger, S., Muhle, P., Bath, P. M., & Dziewas, R. (2024). Dysphagia after stroke: research advances in treatment interventions. Lancet Neurology, 23(4), 418-428. https://doi.org/10.1016/s1474-4422%2824%2900053-x

After a stroke, most patients have dysphagia, which can lead to aspiration pneumonia, malnutrition, and adverse functional outcomes. Protective interventions aimed at reducing these complications remain the cornerstone of treatment. Dietary adjustmen... Read More about Dysphagia after stroke: research advances in treatment interventions.

Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST (2024)
Journal Article
MacDonald, A. S., McConnachie, A., Dickie, D. A., Bath, P. M., Forbes, K., Quinn, T., …Dawson, J. (2024). Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST. Journal of Human Hypertension, https://doi.org/10.1038/s41371-024-00906-5

Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and c... Read More about Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST.

Design of trials in lacunar stroke and cerebral small vessel disease: Review and experience with the LACunar Intervention Trial 2 (LACI-2) (2024)
Journal Article
Blair, G., Appleton, J. P., Doubal, F. N., Mhlanga, I. I., Woodhouse, L. J., Bath, P. M., & Wardlaw, J. (in press). Design of trials in lacunar stroke and cerebral small vessel disease: Review and experience with the LACunar Intervention Trial 2 (LACI-2). Stroke and Vascular Neurology,

Background: Cerebral small vessel disease (cSVD) causes lacunar stroke (25% of ischaemic strokes), haemorrhage, dementia, physical frailty, or is ‘covert’, but has no specific treatment. Uncertainties about the design of clinical trials in cSVD, whic... Read More about Design of trials in lacunar stroke and cerebral small vessel disease: Review and experience with the LACunar Intervention Trial 2 (LACI-2).

Influence of time to achieve target systolic blood pressure on outcome after intracerebral hemorrhage: the Blood Pressure in Acute Stroke Collaboration (2024)
Journal Article
Wang, X., Yang, J., Moullaali, T. J., Sandset, E. C., Woodhouse, L. J., Law, Z. K., …Chalmers, J. (2024). Influence of time to achieve target systolic blood pressure on outcome after intracerebral hemorrhage: the Blood Pressure in Acute Stroke Collaboration. Stroke, https://doi.org/10.1161/strokeaha.123.044358

OBJECTIVE: To investigate whether an earlier time to achieving and maintaining systolic blood pressure (SBP) at 120 to 140 mm Hg is associated with favorable outcomes in a cohort of patients with acute intracerebral hemorrhage. METHODS: We pooled ind... Read More about Influence of time to achieve target systolic blood pressure on outcome after intracerebral hemorrhage: the Blood Pressure in Acute Stroke Collaboration.

Dual Antiplatelet Treatment up to 72 Hours after Ischemic Stroke (2023)
Journal Article
Gao, Y., Chen, W., Pan, Y., Jing, J., Wang, C., Johnston, S. C., …Wang, Y. (2023). Dual Antiplatelet Treatment up to 72 Hours after Ischemic Stroke. New England Journal of Medicine, 389(26), 2413-2424. https://doi.org/10.1056/nejmoa2309137

BACKGROUND: Dual antiplatelet treatment has been shown to lower the risk of recurrent stroke as compared with aspirin alone when treatment is initiated early (≤24 hours) after an acute mild stroke. The effect of clopidogrel plus aspirin as compared w... Read More about Dual Antiplatelet Treatment up to 72 Hours after Ischemic Stroke.

Analysis of Endothelial Progenitor Cell Subtypes as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke (2023)
Journal Article
ABDULKADIR, R., RAKKAR, K., OTHMAN, O., SPRIGG, N., BATH, P., & BAYRAKTUTAN, U. (2023). Analysis of Endothelial Progenitor Cell Subtypes as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke. Scientific Reports, 13, Article 21843. https://doi.org/10.1038/s41598-023-48907-7

Endothelial progenitor cells (EPCs), expressing markers for stemness (CD34), immaturity (CD133) and endothelial maturity (KDR), may determine the extent of post-stroke vascular repair. Given the prevalence of stroke in elderly, this study explored wh... Read More about Analysis of Endothelial Progenitor Cell Subtypes as Clinical Biomarkers for Elderly Patients with Ischaemic Stroke.

Analysis of endothelial progenitor cell subtypes as clinical biomarkers for elderly patients with ischaemic stroke (2023)
Journal Article
Kadir, R. R. A., Rakkar, K., Othman, O. A., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2023). Analysis of endothelial progenitor cell subtypes as clinical biomarkers for elderly patients with ischaemic stroke. Scientific Reports, 13, Article 21843. https://doi.org/10.1038/s41598-023-48907-7

Endothelial progenitor cells (EPCs), expressing markers for stemness (CD34), immaturity (CD133) and endothelial maturity (KDR), may determine the extent of post-stroke vascular repair. Given the prevalence of stroke in elderly, this study explored wh... Read More about Analysis of endothelial progenitor cell subtypes as clinical biomarkers for elderly patients with ischaemic stroke.

Prevention of infections and fever to improve outcome in older patients with acute stroke (PRECIOUS): a randomised, open, phase III, multifactorial, clinical trial with blinded outcome assessment (2023)
Journal Article
de Jonge, J. C., Sluis, W. M., Reinink, H., Bath, P. M., Woodhouse, L. J., Zweedijk, B., …van der Worp, H. B. (2024). Prevention of infections and fever to improve outcome in older patients with acute stroke (PRECIOUS): a randomised, open, phase III, multifactorial, clinical trial with blinded outcome assessment. Lancet Regional Health – Europe, 36, Article 100782. https://doi.org/10.1016/j.lanepe.2023.100782

Background Infections and fever after stroke are associated with poor functional outcome or death. We assessed whether prophylactic treatment with anti-emetic, antibiotic, or antipyretic medication would improve functional outcome in older patient... Read More about Prevention of infections and fever to improve outcome in older patients with acute stroke (PRECIOUS): a randomised, open, phase III, multifactorial, clinical trial with blinded outcome assessment.

Challenges and Experiences in Multicenter Prehospital Stroke Research: Narrative Data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2) (2023)
Journal Article
Dixon, M., Williams, J., Bath, P. M., Investigators, R., & for the RIGHT-2 Investigators. (2023). Challenges and Experiences in Multicenter Prehospital Stroke Research: Narrative Data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2). Prehospital Emergency Care, https://doi.org/10.1080/10903127.2023.2287171

Background: Ambulance services are increasingly research active and the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) is the largest United Kingdom (UK) ambulance-based randomized controlled trial in stroke. We... Read More about Challenges and Experiences in Multicenter Prehospital Stroke Research: Narrative Data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2).

Evaluating artificial intelligence software for delineating hemorrhage extent on CT brain imaging in stroke: AI delineation of ICH on CT. (2023)
Journal Article
Vacek, A., Mair, G., White, P., Bath, P. M., Muir, K. W., Al-Shahi Salman, R., …Wardlaw, J. M. (2024). Evaluating artificial intelligence software for delineating hemorrhage extent on CT brain imaging in stroke: AI delineation of ICH on CT. Journal of Stroke and Cerebrovascular Diseases, 33(1), Article 107512. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107512

Background: : The extent and distribution of intracranial hemorrhage (ICH) directly affects clinical management. Artificial intelligence (AI) software can detect and may delineate ICH extent on brain CT. We evaluated e-ASPECTS software (Brainomix Ltd... Read More about Evaluating artificial intelligence software for delineating hemorrhage extent on CT brain imaging in stroke: AI delineation of ICH on CT..

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.

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.

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).

Key design elements of successful acute ischemic stroke treatment trials (2023)
Journal Article
Yperzeele, L., Shoamanesh, A., Venugopalan, Y. V., Chapman, S., Mazya, M. V., Charalambous, M., …Koltsov, I. (2023). Key design elements of successful acute ischemic stroke treatment trials. Neurological Research and Practice, 5(1), Article 1. https://doi.org/10.1186/s42466-022-00221-9

Purpose: We review key design elements of positive randomized controlled trials (RCTs) in acute ischemic stroke (AIS) treatment and summarize their main characteristics. Method: We searched Medline, Pubmed and Cochrane databases for positive RCTs in... Read More about Key design elements of successful acute ischemic stroke treatment trials.

Genotype-Guided Dual Antiplatelet Use for Transient Ischemic Attack and Minor Stroke by Imaging Status: Subgroup Analysis of the CHANCE-2 Trial (2022)
Journal Article
Jing, J., Xie, X., Johnston, S. C., Bath, P. M., Li, Z., Zhao, X., …for the CHANCE‐2 Investigators. (2023). Genotype-Guided Dual Antiplatelet Use for Transient Ischemic Attack and Minor Stroke by Imaging Status: Subgroup Analysis of the CHANCE-2 Trial. Annals of Neurology, 93(4), 783-792. https://doi.org/10.1002/ana.26589

Objective: This study was performed to investigate whether ticagrelor/aspirin versus clopidogrel/aspirin can further reduce the residual risk of stroke recurrence in patients with positive diffusion-weighted imaging (DWI) in the High-Risk Patients wi... Read More about Genotype-Guided Dual Antiplatelet Use for Transient Ischemic Attack and Minor Stroke by Imaging Status: Subgroup Analysis of the CHANCE-2 Trial.

Ticagrelor Aspirin vs Clopidogrel Aspirin in CYP2C19 Loss-of-Function Carriers with Minor Stroke or TIA Stratified by Risk Profile (2022)
Journal Article
Wang, A., Meng, X., Tian, X., Zuo, Y., Bath, P. M., Li, H., …Wang, Y. (2023). Ticagrelor Aspirin vs Clopidogrel Aspirin in CYP2C19 Loss-of-Function Carriers with Minor Stroke or TIA Stratified by Risk Profile. Neurology, 100(5), e497-e504. https://doi.org/10.1212/WNL.0000000000201454

Background and ObjectiveGenotype data of the Clopidogrel with Aspirin in Acute Minor Stroke or Transient Ischemic Attack (CHANCE) trial showed that efficacy of clopidogrel aspirin depended on CYP2C19 genotype and risk profile. A stratification of pat... Read More about Ticagrelor Aspirin vs Clopidogrel Aspirin in CYP2C19 Loss-of-Function Carriers with Minor Stroke or TIA Stratified by Risk Profile.

Stroke outcome related to initial volume status and diuretic use (2022)
Journal Article
Renner, C., Kasner, S., Bath, P., & Bahouth, M. (2022). Stroke outcome related to initial volume status and diuretic use. Journal of the American Heart Association, 11(24), Article e026903. https://doi.org/10.1161/jaha.122.026903

Background: We hypothesized that stroke outcome is related to multiple baseline hydration-related factors including volume contracted state (VCS) and diuretic use. Methods: We analyzed a prospective cohort of subjects with ischemic stroke

Time intervals and distances travelled for prehospital ambulance stroke care: data from the randomised-controlled ambulance-based Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) (2022)
Journal Article
Dixon, M., Appleton, J. P., Scutt, P., Woodhouse, L. J., Haywood, L. J., Havard, D., …Bath, P. M. (2022). Time intervals and distances travelled for prehospital ambulance stroke care: data from the randomised-controlled ambulance-based Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2). BMJ Open, 12(11), Article e060211. https://doi.org/10.1136/bmjopen-2021-060211

Objectives Ambulances offer the first opportunity to evaluate hyperacute stroke treatments. We investigated the conduct of a hyperacute stroke study in the ambulance-based setting with a particular focus on timings and logistics of trial delivery.... Read More about Time intervals and distances travelled for prehospital ambulance stroke care: data from the randomised-controlled ambulance-based Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2).

Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial (2022)
Journal Article
Bath, P. M., Skinner, C. J. C., Bath, C. S., Woodhouse, L. J., Areti, A., Korovesi, K., …Gordon, A. L. (2022). Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial. European Geriatric Medicine, 13, 1343-1355. https://doi.org/10.1007/s41999-022-00714-5

Purpose Infections cause considerable care home morbidity and mortality. Nitric oxide (NO) has broad-spectrum anti-viral, bacterial and yeast activity in vitro. We assessed the feasibility of supplementing dietary nitrate (NO substrate) intake in ca... Read More about Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial.

Ticagrelor–Aspirin Versus Clopidogrel–Aspirin Among CYP2C19 Loss-of-Function Carriers With Minor Stroke or Transient Ischemic Attack in Relation to Renal Function: A Post Hoc Analysis of the CHANCE-2 Trial (2022)
Journal Article
Wang, A., Xie, X., Tian, X., Johnston, S. C., Li, H., Bath, P. M., …Wang, Y. (2022). Ticagrelor–Aspirin Versus Clopidogrel–Aspirin Among CYP2C19 Loss-of-Function Carriers With Minor Stroke or Transient Ischemic Attack in Relation to Renal Function: A Post Hoc Analysis of the CHANCE-2 Trial. Annals of Internal Medicine, 175(11), 1534-1542. https://doi.org/10.7326/M22-1667

Background: Evidence on the risk–benefit ratio of dual antiplatelet therapies among patients with stroke and impaired renal function is limited and inconsistent. Objective: To investigate the effect of renal function on the efficacy and safety o... Read More about Ticagrelor–Aspirin Versus Clopidogrel–Aspirin Among CYP2C19 Loss-of-Function Carriers With Minor Stroke or Transient Ischemic Attack in Relation to Renal Function: A Post Hoc Analysis of the CHANCE-2 Trial.

Ticagrelor-Aspirin versus Clopidogrel-Aspirin among CYP2C19 Loss-of-Function Carriers with Minor Stroke or TIA in Relation to Renal Function: A Post Hoc Analysis of CHANCE-2 Trial (2022)
Journal Article
Wang, A., Wang, Y., Xie, X., Tian, X., Claiborne Johnston, S., Li, H., …Wang, Y. (2022). Ticagrelor-Aspirin versus Clopidogrel-Aspirin among CYP2C19 Loss-of-Function Carriers with Minor Stroke or TIA in Relation to Renal Function: A Post Hoc Analysis of CHANCE-2 Trial. Annals of Internal Medicine, 175(11), 1534-1542. https://doi.org/10.7326/M22-1667

Background: Evidence on the risk-benefit ratio of dual antiplatelet therapies among stroke patients with impaired renal function is limited and inconsistent. Objective: To investigate the effect of renal function on the efficacy and safety of tic... Read More about Ticagrelor-Aspirin versus Clopidogrel-Aspirin among CYP2C19 Loss-of-Function Carriers with Minor Stroke or TIA in Relation to Renal Function: A Post Hoc Analysis of CHANCE-2 Trial.

Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2) (2022)
Journal Article
Krishnan, K., Law, Z. K., Woodhouse, L. J., Dineen, R. A., Sprigg, N., Wardlaw, J. M., & Bath, P. M. (2023). Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2). Stroke and Vascular Neurology, 8(2), 151-160. https://doi.org/10.1136/svn-2021-001375

Background and purpose: Intracerebral haemorrhage volume (ICHV) is prognostically important but does not account for intracranial volume (ICV) and cerebral parenchymal volume (CPV). We assessed measures of intracranial compartments in acute ICH using... Read More about Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2).

Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning (2022)
Journal Article
Kok, Y. E., Pszczolkowski, S., Law, Z. K., Ali, A., Krishnan, K., Bath, P., …French, A. P. (2022). Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning. Radiology: Artificial Intelligence, 4(6), https://doi.org/10.1148/ryai.220096

This study evaluated deep learning algorithms for semantic segmentation and quantification of intracerebral hemorrhage (ICH), perihematomal edema (PHE), and intraventricular hemorrhage (IVH) on noncontrast CT scans of patients with spontaneous ICH. M... Read More about Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning.

External validation of e-ASPECTS software for interpreting brain CT in stroke (2022)
Journal Article
Mair, G., White, P., Bath, P. M., Muir, K. W., Salman, R. A., Martin, C., …Wardlaw, J. M. (2022). External validation of e-ASPECTS software for interpreting brain CT in stroke. Annals of Neurology, 92(6), 943-957. https://doi.org/10.1002/ana.26495

Objective To test e-ASPECTS software in patients with stroke. Marketed as a decision-support tool, e-ASPECTS may detect features of ischemia or hemorrhage on computed tomography (CT) imaging and quantify ischemic extent using ASPECTS (Alberta Strok... Read More about External validation of e-ASPECTS software for interpreting brain CT in stroke.

Cilostazol and isosorbide mononitrate for the prevention of progression of cerebral small vessel disease: baseline data and statistical analysis plan for the Lacunar Intervention Trial-2 (LACI-2) (ISRCTN14911850) (2022)
Journal Article
Bath, P. M., Mhlanga, I., Woodhouse, L. J., Doubal, F., Oatey, K., Montgomery, A. A., … LACI-2 Trial Investigators. (2023). Cilostazol and isosorbide mononitrate for the prevention of progression of cerebral small vessel disease: baseline data and statistical analysis plan for the Lacunar Intervention Trial-2 (LACI-2) (ISRCTN14911850). Stroke and Vascular Neurology, 8, Article e001816. https://doi.org/10.1136/svn-2022-001816

Background: Cerebral small vessel disease (SVD) causes lacunar strokes (25% of all ischaemic strokes), physical frailty and cognitive impairment and vascular and mixed dementia. There is no specific treatment to prevent progression of SVD. Methods: T... Read More about Cilostazol and isosorbide mononitrate for the prevention of progression of cerebral small vessel disease: baseline data and statistical analysis plan for the Lacunar Intervention Trial-2 (LACI-2) (ISRCTN14911850).

Development of a core outcome set for the evaluation of interventions to prevent COVID-19 in care homes (COS-COVID-PCARE Study) (2022)
Journal Article
Shepherd, V., Islam, I., Wood, F., Williamson, P. R., Goodman, C., Bath, P. M., …Hood, K. (2022). Development of a core outcome set for the evaluation of interventions to prevent COVID-19 in care homes (COS-COVID-PCARE Study). BMC Geriatrics, 22(1), Article 710. https://doi.org/10.1186/s12877-022-03395-8

Background: People living in care homes have experienced devastating impact from COVID-19. As interventions to prevent the transmission of COVID-19 are developed and evaluated, there is an urgent need for researchers to agree on the outcomes used whe... Read More about Development of a core outcome set for the evaluation of interventions to prevent COVID-19 in care homes (COS-COVID-PCARE Study).

Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion (2022)
Journal Article
Seiffge, D. J., Polymeris, A. A., Law, Z. K., Krishnan, K., Zietz, A., Thilemann, S., …Peters, N. (2022). Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion. Annals of Neurology, 92(6), 921-930. https://doi.org/10.1002/ana.26481

Objective: We assessed whether hematoma expansion (HE) and favorable outcome differ according to type of intracerebral hemorrhage (ICH). Methods: Among participants with ICH enrolled in the TICH-2 (Tranexamic Acid for Hyperacute Primary Intracerebral... Read More about Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion.

Framework for Clinical Trials in Cerebral Small Vessel Disease (FINESSE): A Review (2022)
Journal Article
Markus, H. S., Van Der Flier, W. M., Smith, E. E., Bath, P., Biessels, G. J., Briceno, E., …Dichgans, M. (2022). Framework for Clinical Trials in Cerebral Small Vessel Disease (FINESSE): A Review. JAMA Neurology, https://doi.org/10.1001/jamaneurol.2022.2262

Importance: Cerebral small vessel disease (SVD) causes a quarter of strokes and is the most common pathology underlying vascular cognitive impairment and dementia. An important step to developing new treatments is better trial methodology. Disease me... Read More about Framework for Clinical Trials in Cerebral Small Vessel Disease (FINESSE): A Review.

The role of CYP2C19 genotyping to guide antiplatelet therapy following ischemic stroke or transient ischemic attack (2022)
Journal Article
McDermott, J. H., Leach, M., Sen, D., Smith, C. J., Newman, W. G., & Bath, P. M. (2022). The role of CYP2C19 genotyping to guide antiplatelet therapy following ischemic stroke or transient ischemic attack. Expert Review of Clinical Pharmacology, 15, 811-825. https://doi.org/10.1080/17512433.2022.2108401

Introduction: Clopidogrel is an antiplatelet agent recommended for secondary prevention of ischemic stroke (IS) and transient ischemic attack (TIA). Conversion of clopidogrel to its active metabolite by hepatic cytochrome P450-2C19 (CYP2C19) is essen... Read More about The role of CYP2C19 genotyping to guide antiplatelet therapy following ischemic stroke or transient ischemic attack.

Time Course for Benefit and Risk with Ticagrelor and Aspirin in Individuals with Acute Ischemic Stroke or Transient Ischemic Attack Who Carry CYP2C19 Loss-of-Function Alleles: A Secondary Analysis of the CHANCE-2 Randomized Clinical Trial (2022)
Journal Article
Pan, Y., Meng, X., Jin, A., Johnston, S. C., Li, H., Bath, P. M., …Wang, Y. (2022). Time Course for Benefit and Risk with Ticagrelor and Aspirin in Individuals with Acute Ischemic Stroke or Transient Ischemic Attack Who Carry CYP2C19 Loss-of-Function Alleles: A Secondary Analysis of the CHANCE-2 Randomized Clinical Trial. JAMA Neurology, https://doi.org/10.1001/jamaneurol.2022.1457

Importance: Dual antiplatelet therapy (DAPT) with ticagrelor and aspirin has been found to be effective for secondary prevention after minor ischemic stroke or transient ischemic attack (TIA) in individuals who carry CYP2C19 loss-of-function (LOF) al... Read More about Time Course for Benefit and Risk with Ticagrelor and Aspirin in Individuals with Acute Ischemic Stroke or Transient Ischemic Attack Who Carry CYP2C19 Loss-of-Function Alleles: A Secondary Analysis of the CHANCE-2 Randomized Clinical Trial.

Association Between Use of a Flying Intervention Team vs Patient Interhospital Transfer and Time to Endovascular Thrombectomy Among Patients With Acute Ischemic Stroke in Nonurban Germany (2022)
Journal Article
Hubert, G. J., Hubert, N. D., Maegerlein, C., Kraus, F., Wiestler, H., Müller-Barna, P., …Haberl, R. L. (2022). Association Between Use of a Flying Intervention Team vs Patient Interhospital Transfer and Time to Endovascular Thrombectomy Among Patients With Acute Ischemic Stroke in Nonurban Germany. Journal of the American Medical Association, 327(18), 1795-1805. https://doi.org/10.1001/jama.2022.5948

Importance: The benefit of endovascular thrombectomy (EVT) for acute ischemic stroke is highly time-dependent, and it is challenging to expedite treatment for patients in remote areas. Objective: To determine whether deployment of a flying interventi... Read More about Association Between Use of a Flying Intervention Team vs Patient Interhospital Transfer and Time to Endovascular Thrombectomy Among Patients With Acute Ischemic Stroke in Nonurban Germany.

Perfusion Imaging for Endovascular Thrombectomy in Acute Ischemic Stroke Is Associated With Improved Functional Outcomes in the Early and Late Time Windows (2022)
Journal Article
Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., …England, T. J. (2022). Perfusion Imaging for Endovascular Thrombectomy in Acute Ischemic Stroke Is Associated With Improved Functional Outcomes in the Early and Late Time Windows. Stroke, 53(9), 2770–2778. https://doi.org/10.1161/STROKEAHA.121.038010

Background: The impact on clinical outcomes of patient selection using perfusion imaging for endovascular thrombectomy (EVT) in patients with acute ischemic stroke presenting beyond 6 hours from onset remains undetermined in routine clinical practice... Read More about Perfusion Imaging for Endovascular Thrombectomy in Acute Ischemic Stroke Is Associated With Improved Functional Outcomes in the Early and Late Time Windows.

Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial (2022)
Journal Article
Pszczolkowski, S., Sprigg, N., Woodhouse, L. J., Gallagher, R., Swienton, D., Law, Z. K., …Dineen, R. A. (2022). Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial. JAMA Neurology, 79(5), 468-477. https://doi.org/10.1001/jamaneurol.2022.0217

Importance: Hyperintense foci on diffusion-weighted imaging (DWI) that are spatially remote from the acute hematoma occur in 20% of people with acute spontaneous intracerebral hemorrhage (ICH). Tranexamic acid, a hemostatic agent that is under invest... Read More about Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial.

Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection (2022)
Journal Article
Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., …England, T. J. (2023). Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection. Journal of NeuroInterventional Surgery, 15(4), 336-342. https://doi.org/10.1136/neurintsurg-2021-018564

Background: The effectiveness and safety of endovascular thrombectomy (EVT) in the late window (6-24 hours) for acute ischemic stroke (AIS) patients selected without advanced imaging is undetermined. We aimed to assess clinical outcomes and the relat... Read More about Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection.

The COVID-19 pandemic has highlighted the need to invest in care home research infrastructure (2022)
Journal Article
Gordon, A. L., Rick, C., Juszczak, E., Montgomery, A., Howard, R., Guthrie, B., …Tate, V. (2022). The COVID-19 pandemic has highlighted the need to invest in care home research infrastructure. Age and Ageing, 51(3), Article afac052. https://doi.org/10.1093/ageing/afac052

The COVID-19 pandemic resulted in catastrophic levels of morbidity and mortality for care home residents. Despite this, research platforms for COVID-19 in care homes arrived late in the pandemic compared with other care settings. The Prophylactic The... Read More about The COVID-19 pandemic has highlighted the need to invest in care home research infrastructure.

Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial (2022)
Journal Article
Woodhouse, L. J., Appleton, J. P., Scutt, P., Everton, L., Wilkinson, G., Caso, V., …Bath, P. M. (2022). Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial. eClinicalMedicine, 44, Article 101274. https://doi.org/10.1016/j.eclinm.2022.101274

Background: It is not known whether to continue or temporarily stop existing antihypertensive drugs in patients with acute stroke. Methods: We performed a prospective subgroup analysis of patients enrolled into the Efficacy of Nitric Oxide in Stroke... Read More about Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial.

Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial (2022)
Journal Article
Tunnage, B., Woodhouse, L. J., Dixon, M., Anderson, C. S., Ankolekar, S., Appleton, J. P., …Bath, P. M. (2022). Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial. BMC Emergency Medicine, 22(1), Article 2. https://doi.org/10.1186/s12873-021-00560-x

Background: Prehospital stroke trials will inevitably recruit patients with non-stroke conditions, so called stroke mimics. We undertook a pre-specified analysis to determine outcomes in patients with mimics in the second Rapid Intervention with Glyc... Read More about Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance 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.

Ticagrelor versus Clopidogrel in CYP2C19 Loss-of-Function Carriers with Stroke or TIA (2021)
Journal Article
Wang, Y., Meng, X., Wang, A., Xie, X., Pan, Y., Johnston, S. C., …CHANCE-2 Investigators. (2021). Ticagrelor versus Clopidogrel in CYP2C19 Loss-of-Function Carriers with Stroke or TIA. New England Journal of Medicine, 385(27), 2520-2530. https://doi.org/10.1056/NEJMoa2111749

BACKGROUND Comparisons between ticagrelor and clopidogrel for the secondary prevention of stroke in CYP2C19 loss-of-function carriers have not been extensively performed. METHODS We conducted a randomized, double-blind, placebo-controlled trial at 20... Read More about Ticagrelor versus Clopidogrel in CYP2C19 Loss-of-Function Carriers with Stroke or TIA.

Primary stroke prevention worldwide: translating evidence into action (2021)
Journal Article
Owolabi, M. O., Thrift, A. G., Mahal, A., Ishida, M., Martins, S., Johnson, W. D., …Imran Musa, K. (2022). Primary stroke prevention worldwide: translating evidence into action. Lancet Public Health, 7(1), e74-e85. https://doi.org/10.1016/s2468-2667%2821%2900230-9

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health... Read More about Primary stroke prevention worldwide: translating evidence into action.

Associations of Early Systolic Blood Pressure Control and Outcome after Thrombolysis-Eligible Acute Ischemic Stroke: Results from the ENCHANTED Study (2021)
Journal Article
Wang, X., Minhas, J. S., Moullaali, T. J., Luca Di Tanna, G., Lindley, R. I., Chen, X., …Robinson, T. G. (2022). Associations of Early Systolic Blood Pressure Control and Outcome after Thrombolysis-Eligible Acute Ischemic Stroke: Results from the ENCHANTED Study. Stroke, 53(3), 779-787. https://doi.org/10.1161/strokeaha.121.034580

Background and Purpose: In thrombolysis-eligible patients with acute ischemic stroke, there is uncertainty over the most appropriate systolic blood pressure (SBP) lowering profile that provides an optimal balance of potential benefit (functional reco... Read More about Associations of Early Systolic Blood Pressure Control and Outcome after Thrombolysis-Eligible Acute Ischemic Stroke: Results from the ENCHANTED Study.

Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials (2021)
Journal Article
Woodhouse, L. J., Montgomery, A. A., Mant, J., Davis, B. R., Algra, A., Mas, J., …Bath, P. M. (2021). Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials. BMC Medical Research Methodology, 21, Article 218. https://doi.org/10.1186/s12874-021-01388-6

Background: Vascular prevention trials typically use dichotomous event outcomes although this may be inefficient statistically and gives no indication of event severity. We assessed whether ordinal outcomes would be more efficient and how to best ana... Read More about Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials.

Nitric oxide for the prevention and treatment of viral, bacterial, protozoal and fungal infections [version 1; peer review: 1 approved with reservations] (2021)
Journal Article
Bath, P. M., Coleman, C. M., Gordon, A. L., Lim, W. S., & Webb, A. J. (2021). Nitric oxide for the prevention and treatment of viral, bacterial, protozoal and fungal infections [version 1; peer review: 1 approved with reservations]. F1000Research, 10, 1-34. https://doi.org/10.12688/f1000research.51270.1

Although the antimicrobial potential of nitric oxide (NO) is widely published, it is little used clinically. NO is a key signalling molecule modulating vascular, neuronal, inflammatory and immune responses. Endogenous antimicrobial activity is largel... Read More about Nitric oxide for the prevention and treatment of viral, bacterial, protozoal and fungal infections [version 1; peer review: 1 approved with reservations].

Effects of Pharyngeal Electrical Stimulation on Swallow Timings, Clearance and Safety in Post-Stroke Dysphagia: Analysis from the Swallowing Treatment Using Electrical Pharyngeal Stimulation (STEPS) Trial (2021)
Journal Article
Everton, L. F., Benfield, J. K., Michou, E., Hamdy, S., & Bath, P. M. (2021). Effects of Pharyngeal Electrical Stimulation on Swallow Timings, Clearance and Safety in Post-Stroke Dysphagia: Analysis from the Swallowing Treatment Using Electrical Pharyngeal Stimulation (STEPS) Trial. Stroke Research and Treatment, 2021, Article 5520657. https://doi.org/10.1155/2021/5520657

Swallowing impairment (dysphagia) post-stroke results in poorer outcomes. Pharyngeal electrical stimulation (PES) is a potential treatment for post-stroke dysphagia. In a post hoc analysis, we investigated PES using videofluoroscopy swallow studies (... Read More about Effects of Pharyngeal Electrical Stimulation on Swallow Timings, Clearance and Safety in Post-Stroke Dysphagia: Analysis from the Swallowing Treatment Using Electrical Pharyngeal Stimulation (STEPS) Trial.

Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke (2021)
Journal Article
Benfield, J. K., Wilkinson, G., Everton, L. F., Bath, P. M., & England, T. J. (2021). Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke. European Journal of Neurology, 28(8), 2766-2774. https://doi.org/10.1111/ene.14900

Background and purpose Comprehensive swallow screening assessments to identify dysphagia and make early eating and drinking recommendations can be used by trained nurses. This study aimed to validate the Dysphagia Trained Nurse Assessment (DTNAx) to... Read More about Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke.

Glyceryl trinitrate for the treatment of ischaemic stroke: Determining efficacy in rodent and ovine species for enhanced clinical translation (2021)
Journal Article
Sorby-Adams, A. J., Learoyd, A. E., Bath, P. M., Burrows, F., Farr, T. D., Leonard, A. V., …Trueman, R. C. (2021). Glyceryl trinitrate for the treatment of ischaemic stroke: Determining efficacy in rodent and ovine species for enhanced clinical translation. Journal of Cerebral Blood Flow and Metabolism, 41(12), 3248-3259. https://doi.org/10.1177/0271678X211018901

Hypertension is a leading risk factor for death and dependency after ischaemic stroke. However, administering anti-hypertensive medications post-stroke remains contentious with concerns regarding deleterious effects on cerebral blood flow and infarct... Read More about Glyceryl trinitrate for the treatment of ischaemic stroke: Determining efficacy in rodent and ovine species for enhanced clinical translation.

Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients With or Without Spot Sign (2021)
Journal Article
Ovesen, C., Jakobsen, J. C., Gluud, C., Steiner, T., Law, Z., Flaherty, K., …Christensen, H. (2021). Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients With or Without Spot Sign. Stroke, 52(8), 2629-2636. https://doi.org/10.1161/strokeaha.120.032426

Background and Purpose: The computed tomography angiography or contrast-enhanced computed tomography based spot sign has been proposed as a biomarker for identifying on-going hematoma expansion in patients with acute intracerebral hemorrhage. We inv... Read More about Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients With or Without Spot Sign.

European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage (2021)
Journal Article
Sandset, E. C., Anderson, C. S., Bath, P. M., Christensen, H., Fischer, U., Manning, L. S., …Tsivgoulis, G. (2021). European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage. European Stroke Journal, 6(2), XLVIII-LXXXIX. https://doi.org/10.1177/23969873211012133

Introduction: The optimal blood pressure (BP) management in acute ischaemic stroke (AIS) and acute intracerebral haemorrhage (ICH) remains controversial. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to as... Read More about European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage.

Clopidogrel with aspirin in High-risk patients with Acute Non-disabling Cerebrovascular Events II (CHANCE-2): rationale and design of a multicenter randomised trial (2021)
Journal Article
Wang, Y., Claiborne Johnston, S., Bath, P. M., Meng, X., Jing, J., Xie, X., …Li, H. (2021). Clopidogrel with aspirin in High-risk patients with Acute Non-disabling Cerebrovascular Events II (CHANCE-2): rationale and design of a multicenter randomised trial. Stroke and Vascular Neurology, 6(2), Article e000791. https://doi.org/10.1136/svn-2020-000791

Background: In patients with a minor ischaemic stroke or transient ischaemic attack (TIA), separate trials have shown that dual antiplatelet therapy with clopidogrel plus aspirin (clopidogrel–aspirin) or ticagrelor plus aspirin (ticagrelor–aspirin) a... Read More about Clopidogrel with aspirin in High-risk patients with Acute Non-disabling Cerebrovascular Events II (CHANCE-2): rationale and design of a multicenter randomised 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.

Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage (2021)
Journal Article
Pszczolkowski, S., Manzano-Patron, 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 clinica... Read More about Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage.

The “Flying Intervention Team”: A Novel Stroke Care Concept for Rural Areas (2021)
Journal Article
Hubert, G. J., Kraus, F., Maegerlein, C., Platen, S., Friedrich, B., Kain, H., …Haberl, R. L. (2021). The “Flying Intervention Team”: A Novel Stroke Care Concept for Rural Areas. Cerebrovascular Diseases, 50(4), 375–382. https://doi.org/10.1159/000514845

Background: Endovascular treatment of large vessel occlusion in acute ischemic stroke patients is difficult to establish in remote areas, and time dependency of treatment effect increases the urge to develop health care concepts for this population.... Read More about The “Flying Intervention Team”: A Novel Stroke Care Concept for Rural Areas.

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.

Pilot Randomised Evaluation of Singing in Dementia (PRESIDE): protocol for a two-arm, parallel group randomised controlled feasibility study with waiting-list control (2021)
Journal Article
Dowson, B., Schneider, J., Guo, B., Bath, P. M., Mcdermott, O., Haywood, L. J., & Orrell, M. (2021). Pilot Randomised Evaluation of Singing in Dementia (PRESIDE): protocol for a two-arm, parallel group randomised controlled feasibility study with waiting-list control. Pilot and Feasibility Studies, 7, Article 15. https://doi.org/10.1186/s40814-020-00759-y

Background As the number of people living with dementia grows, so does the need to provide them with adequate psychosocial support. Many people with dementia live at home with family carers, who also require social and emotional support to cope wi... Read More about Pilot Randomised Evaluation of Singing in Dementia (PRESIDE): protocol for a two-arm, parallel group randomised controlled feasibility study with waiting-list control.

Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial (2020)
Journal Article
Appleton, J. P., O'Sullivan, S. E., Hedstrom, A., May, J. A., Donnelly, R., Sprigg, N., …England, T. J. (2021). Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial. European Journal of Neurology, 28(4), 1225-1233. https://doi.org/10.1111/ene.14650

Background and purpose: Remote ischaemic per-conditioning (RIC) is neuroprotective in experimental ischaemic stroke. Several neurohumoral, vascular and inflammatory mediators are implicated. The effect of RIC on plasma biomarkers was assessed using c... Read More about Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial.

Desmopressin for reversal of Antiplatelet drugs in Stroke due to Haemorrhage (DASH): protocol for a phase II double blind randomised controlled feasibility trial (2020)
Journal Article
Desborough, M. J., Al-Shahi Salman, R., Stanworth, S. J., Havard, D., Brennan, P. M., Dineen, R. A., …DASH trial investigators. (2020). Desmopressin for reversal of Antiplatelet drugs in Stroke due to Haemorrhage (DASH): protocol for a phase II double blind randomised controlled feasibility trial. BMJ Open, 10(11), Article e037555. https://doi.org/10.1136/bmjopen-2020-037555

Introduction Intracerebral haemorrhage (ICH) can be devastating and is a common cause of death and disability worldwide. Pre-ICH antiplatelet drug use is associated with a 27% relative increase in 1 month case fatality compared with patients not usin... Read More about Desmopressin for reversal of Antiplatelet drugs in Stroke due to Haemorrhage (DASH): protocol for a phase II double blind randomised controlled feasibility trial.

Relationship between nitrate headache and outcome in patients with acute stroke: results from the efficacy of nitric oxide in stroke (ENOS) trial (2020)
Journal Article
Beishon, L., Woodhouse, L. J., Bereczki, D., Christensen, H. K., Collins, R., Gommans, J., …Bath, P. M. (2021). Relationship between nitrate headache and outcome in patients with acute stroke: results from the efficacy of nitric oxide in stroke (ENOS) trial. Stroke and Vascular Neurology, 6(2), 180-186. https://doi.org/10.1136/svn-2020-000498

Introduction Nitrate-induced headache is common and may signify responsive cerebral vasculature. We assessed the relationship between nitrate headache and outcome in patients with acute stroke. Materials and methods Patients were those randomised to... Read More about Relationship between nitrate headache and outcome in patients with acute stroke: results from the efficacy of nitric oxide in stroke (ENOS) trial.

Pharyngeal electrical stimulation for neurogenic dysphagia following stroke, traumatic brain injury or other causes: Main results from the PHADER cohort study (2020)
Journal Article
Bath, P. M., Woodhouse, L. J., Suntrup-Krueger, S., Likar, R., Koestenberger, M., Warusevitane, A., …Dziewas, R. (2020). Pharyngeal electrical stimulation for neurogenic dysphagia following stroke, traumatic brain injury or other causes: Main results from the PHADER cohort study. EClinicalMedicine, 28, Article 100608. https://doi.org/10.1016/j.eclinm.2020.100608

Background: Neurogenic dysphagia is common and has no definitive treatment. We assessed whether pharyngeal electrical stimulation (PES) is associated with reduced dysphagia. Methods: The PHAryngeal electrical stimulation for treatment of neurogenic D... Read More about Pharyngeal electrical stimulation for neurogenic dysphagia following stroke, traumatic brain injury or other causes: Main results from the PHADER cohort study.

Intracranial Bleeding After Reperfusion Therapy in Acute Ischaemic Stroke Patients Randomized to Glyceryl Trinitrate vs. Control: An Individual Patient Data Meta-Analysis (2020)
Journal Article
Appleton, J. P., Woodhouse, L. J., Sprigg, N., Wardlaw, J. M., & Bath, P. M. (2020). Intracranial Bleeding After Reperfusion Therapy in Acute Ischaemic Stroke Patients Randomized to Glyceryl Trinitrate vs. Control: An Individual Patient Data Meta-Analysis. Frontiers in Neurology, 11, Article 584038. https://doi.org/10.3389/fneur.2020.584038

Background: Thrombolysis, with or without thrombectomy, for acute ischaemic stroke is associated with an increased risk of intracranial bleeding. We assessed whether treatment with glyceryl trinitrate (GTN), a nitric oxide donor, may influence the as... Read More about Intracranial Bleeding After Reperfusion Therapy in Acute Ischaemic Stroke Patients Randomized to Glyceryl Trinitrate vs. Control: An Individual Patient Data Meta-Analysis.

Rates, risks and routes to reduce vascular dementia (R4vad), a UK-wide multicentre prospective observational cohort study of cognition after stroke: Protocol (2020)
Journal Article
Wardlaw, J. M., Doubal, F., Brown, R., Backhouse, E., Woodhouse, L., Bath, P., …R4VaD Investigators. (2021). Rates, risks and routes to reduce vascular dementia (R4vad), a UK-wide multicentre prospective observational cohort study of cognition after stroke: Protocol. European Stroke Journal, 6(1), 89-101. https://doi.org/10.1177/2396987320953312

Background: Stroke commonly affects cognition and, by definition, much vascular dementia follows stroke. However, there are fundamental limitations in our understanding of vascular cognitive impairment, restricting understanding of prevalence, trajec... Read More about Rates, risks and routes to reduce vascular dementia (R4vad), a UK-wide multicentre prospective observational cohort study of cognition after stroke: Protocol.

Comparative effects of intensive-versus standard-BP lowering treatment in patients with severe ischemic stroke in the ENCHANTED trial (2020)
Journal Article
Minhas, J. S., Wang, X., Lindley, R. I., Delcourt, C., Song, L., Woodward, M., …Robinson, T. G. (2021). Comparative effects of intensive-versus standard-BP lowering treatment in patients with severe ischemic stroke in the ENCHANTED trial. Journal of Hypertension, 39(2), 280-285. https://doi.org/10.1097/hjh.0000000000002640

Objective: Limited data exist on the optimum level of systolic blood pressure (BP) in thrombolyzed patients with acute ischemic stroke (AIS). We aimed to determine the effects of intensive BP lowering, specifically in patients with severe AIS who par... Read More about Comparative effects of intensive-versus standard-BP lowering treatment in patients with severe ischemic stroke in the ENCHANTED trial.

Clinical management of cerebral small vessel disease: a call for a holistic approach (2020)
Journal Article
Clancy, U., Appleton, J. P., Arteaga, C., Doubal, F. N., Bath, P. M., & Wardlaw, J. M. (2021). Clinical management of cerebral small vessel disease: a call for a holistic approach. Chinese Medical Journal, 134(2), 127-142. https://doi.org/10.1097/cm9.0000000000001177

Cerebral small vessel disease (SVD) is a common global brain disease that causes cognitive impairment, ischemic or hemorrhagic stroke, problems with mobility, and neuropsychiatric symptoms. The brain damage, seen as focal white and deep grey matter l... Read More about Clinical management of cerebral small vessel disease: a call for a holistic approach.

Remote platelet function testing using P-selectin expression in patients with recent cerebral ischaemia on clopidogrel (2020)
Journal Article
Appleton, J. P., Richardson, C., Dovlatova, N., May, J., Sprigg, N., Heptinstall, S., & Bath, P. M. (2021). Remote platelet function testing using P-selectin expression in patients with recent cerebral ischaemia on clopidogrel. Stroke and Vascular Neurology, 6(1), 103-108. https://doi.org/10.1136/svn-2020-000346

Background Antiplatelet agents reduce recurrence after cerebral ischaemia but are not effective in all patients, in part because of treatment resistance. The primary aim was to assess the proportion of patients who are insensitive to clopidogrel. The... Read More about Remote platelet function testing using P-selectin expression in patients with recent cerebral ischaemia on clopidogrel.

Data sharing: experience of accessing individual patient data from completed randomised controlled trials in vascular and cognitive medicine (2020)
Journal Article
Scutt, P., Woodhouse, L. J., Montgomery, A. A., & Bath, P. M. .. (2020). Data sharing: experience of accessing individual patient data from completed randomised controlled trials in vascular and cognitive medicine. BMJ Open, 10(9), Article e038765. https://doi.org/10.1136/bmjopen-2020-038765

Objectives Meta-analysis based on individual patient data (IPD) from randomised trials is superior to using published summary data since it facilitates subgroup and multiple variable analyses. Guidelines and funders expect that researchers share IPD... Read More about Data sharing: experience of accessing individual patient data from completed randomised controlled trials in vascular and cognitive medicine.

Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial (2020)
Journal Article
Kang Law, Z., Dineen, R., England, T. J., Cala, L., Mistri, A. K., Appleton, J. P., …TICH-2 investigators. (2021). Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial. Translational Stroke Research, 12, 275-283. https://doi.org/10.1007/s12975-020-00845-6

Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexa... Read More about Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial.

Tackling challenges in care of Alzheimer's disease and other dementias amid the COVID‐19 pandemic, now and in the future (2020)
Journal Article
Mok, V. C., Pendlebury, S., Wong, A., Alladi, S., Au, L., Bath, P., …Scheltens, P. (2020). Tackling challenges in care of Alzheimer's disease and other dementias amid the COVID‐19 pandemic, now and in the future. Alzheimer's and Dementia, 16(11), 1571-1581. https://doi.org/10.1002/alz.12143

We have provided an overview on the profound impact of COVID‐19 upon older people with Alzheimer's disease and other dementias and the challenges encountered in our management of dementia in different health‐care settings, including hospital, out‐pat... Read More about Tackling challenges in care of Alzheimer's disease and other dementias amid the COVID‐19 pandemic, now and in the future.

Methodologies for pragmatic and efficient assessment of benefits and harms: Application to the SOCRATES trial (2020)
Journal Article
Evans, S. R., Knutsson, M., Amarenco, P., Albers, G. W., Bath, P. M., Denison, H., …Johnston, S. C. (2020). Methodologies for pragmatic and efficient assessment of benefits and harms: Application to the SOCRATES trial. Clinical Trials, 17(6), 617-626. https://doi.org/10.1177/1740774520941441

Background/Aims: Standard approaches to trial design and analyses can be inefficient and non-pragmatic. Failure to consider a range of outcomes impedes evidence-based interpretation and reduces power. Traditional approaches synthesizing information o... Read More about Methodologies for pragmatic and efficient assessment of benefits and harms: Application to the SOCRATES trial.

Cost-benefit of outcome adjudication in nine randomised stroke trials (2020)
Journal Article
Godolphin, P. J., Bath, P. M., Algra, A., Berge, E., Chalmers, J., Eliasziw, M., …Montgomery, A. A. (2020). Cost-benefit of outcome adjudication in nine randomised stroke trials. Clinical Trials, 17(5), 576-580. https://doi.org/10.1177/1740774520939231

Background: Central adjudication of outcomes is common for randomised trials and should control for differential misclassification. However, few studies have estimated the cost of the adjudication process. Methods: We estimated the cost of adjudicat... Read More about Cost-benefit of outcome adjudication in nine randomised stroke trials.

Cilostazol for Secondary Prevention of Stroke and Cognitive Decline: Systematic Review and Meta-Analysis (2020)
Journal Article
McHutchison, C., Blair, G. W., Appleton, J. P., Chappell, F. M., Doubal, F., Bath, P. M., & Wardlaw, J. M. (2020). Cilostazol for Secondary Prevention of Stroke and Cognitive Decline: Systematic Review and Meta-Analysis. Stroke, 51(8), 2374-2385. https://doi.org/10.1161/strokeaha.120.029454

Background and Purpose: Cilostazol, a phosphodiesterase 3’ inhibitor, is used in Asia-Pacific countries for stroke prevention, but rarely used elsewhere. In addition to weak antiplatelet effects, it stabilises endothelium, aids myelin repair and astr... Read More about Cilostazol for Secondary Prevention of Stroke and Cognitive Decline: Systematic Review and Meta-Analysis.

Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis (2020)
Journal Article
Lim, S. T., Thijs, V., Murphy, S. J. X., Fernandez-Cadenas, I., Montaner, J., Offiah, C., …McCabe, D. J. H. (2020). Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis. Journal of Neurology, https://doi.org/10.1007/s00415-020-09932-y

Background The prevalence of ex vivo ‘high on-treatment platelet reactivity (HTPR)’ and its relationship with recurrent vascular events/outcomes in patients with ischaemic cerebrovascular disease (CVD) is unclear. Methods A systematic review and... Read More about Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis.

The Landscape of Videofluoroscopy in the UK: A Web-Based Survey (2020)
Journal Article
Benfield, J. K., Michou, E., Everton, L. F., Mills, C., Hamdy, S., Bath, P. M., & England, T. J. (2020). The Landscape of Videofluoroscopy in the UK: A Web-Based Survey. Dysphagia, https://doi.org/10.1007/s00455-020-10130-1

Videofluoroscopy (VFS) is considered one of the gold-standard assessments of swallowing. Whilst guidelines for the application and conduct of VFS exist, their translation into clinical practice remain challenging. To build a greater understanding on... Read More about The Landscape of Videofluoroscopy in the UK: A Web-Based Survey.

Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients (2020)
Journal Article
Everton, L. F., Benfield, J. K., Hedstrom, A., Wilkinson, G., Michou, E., England, T. J., …Hamdy, S. (2020). Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients. Scientific Reports, 10, Article 7268. https://doi.org/10.1038/s41598-020-64208-9

Post stroke dysphagia (PSD) is common and associated with poor outcome. The Dysphagia Severity Rating Scale (DSRS), which grades how severe dysphagia is based on fluid and diet modification and supervision requirements for feeding, is used for clinic... Read More about Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients.

Real-world Independent Testing of e-ASPECTS Software (RITeS): statistical analysis plan (2020)
Journal Article
Mair, G., Chappell, F., Martin, C., Dye, D., Bath, P. M., Muir, K. W., …Wardlaw, J. M. (2020). Real-world Independent Testing of e-ASPECTS Software (RITeS): statistical analysis plan. AMRC Open Research, 2, Article 20. https://doi.org/10.12688/amrcopenres.12904.1

Background: Artificial intelligence-based software may automatically detect ischaemic stroke lesions and provide an Alberta Stroke Program Early CT score (ASPECTS) on CT, and identify arterial occlusion and provide a collateral score on CTA. Large-sc... Read More about Real-world Independent Testing of e-ASPECTS Software (RITeS): statistical analysis plan.

Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease (2020)
Journal Article
Wardlaw, J., Bath, P. M., Doubal, F., Heye, A., Sprigg, N., Woodhouse, L. J., …The LACI-2 Trial Investigators. (2020). Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease. European Stroke Journal, 5(3), 297-308. https://doi.org/10.1177/2396987320920110

Background Small vessel disease causes a quarter of ischaemic strokes (lacunar subtype), up to 45% of dementia either as vascular or mixed types, cognitive impairment and physical frailty. However, there is no specific treatment to prevent progressi... Read More about Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease.

UK consensus on pre-clinical vascular cognitive impairment functional outcomes assessment: questionnaire and workshop proceedings (2020)
Journal Article
McColl, B. W., Allan, S. M., McFall, A., Hietamies, T. M., Bernard, A., Aimable, M., …Quinn, T. J. (2020). UK consensus on pre-clinical vascular cognitive impairment functional outcomes assessment: questionnaire and workshop proceedings. Journal of Cerebral Blood Flow and Metabolism, 40(7), 1402-1414. https://doi.org/10.1177/0271678x20910552

© The Author(s) 2020. Assessment of outcome in preclinical studies of vascular cognitive impairment (VCI) is heterogenous. Through an ARUK Scottish Network supported questionnaire and workshop (mostly UK-based researchers), we aimed to determine unde... Read More about UK consensus on pre-clinical vascular cognitive impairment functional outcomes assessment: questionnaire and workshop proceedings.

Intracerebral implantation of human neural stem cells and motor recovery after stroke: multicentre prospective single-arm study (PISCES-2) (2020)
Journal Article
Muir, K. W., Bulters, D., Willmot, M., Sprigg, N., Dixit, A., Ward, N., …Sinden, J. (2020). Intracerebral implantation of human neural stem cells and motor recovery after stroke: multicentre prospective single-arm study (PISCES-2). Journal of Neurology, Neurosurgery and Psychiatry, 91(4), 396-401. https://doi.org/10.1136/jnnp-2019-322515

Background Human neural stem cell implantation may offer improved recovery from stroke. We investigated the feasibility of intracerebral implantation of the allogeneic human neural stem cell line CTX0E03 in the subacute—chronic recovery phase of... Read More about Intracerebral implantation of human neural stem cells and motor recovery after stroke: multicentre prospective single-arm study (PISCES-2).

Improving economic evaluations in stroke: A report from the ESO Health Economics Working Group (2020)
Journal Article
Wilson, A., on behalf of the ESO Health Economics Working group, Cadilhac, D. A., Kim, J., Berge, E., Patel, A., …Ranta, A. (2020). Improving economic evaluations in stroke: A report from the ESO Health Economics Working Group. European Stroke Journal, 5(2), 184-192. https://doi.org/10.1177/2396987319897466

Abstract Introduction: Approaches to economic evaluations of stroke therapies are varied and inconsistently described. An objective of the European Stroke Organisation (ESO) Health Economics Working Group is to standardise and improve the economic ev... Read More about Improving economic evaluations in stroke: A report from the ESO Health Economics Working Group.

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.

Elevated plasminogen activators are associated with hematoma progression in spontaneous intracerebral hemorrhage (2020)
Journal Article
Law, Z. K., Desborough, M., Rakkar, K., Bath, P. M., Bayraktutan, U., & Sprigg, N. (2020). Elevated plasminogen activators are associated with hematoma progression in spontaneous intracerebral hemorrhage. Brain Hemorrhages, 1(1), 75-79. https://doi.org/10.1016/j.hest.2019.12.001

Endogenous fibrinolysis might lead to hematoma progression in spontaneous intracerebral hemorrhage (ICH). We studied plasma biomarkers of fibrinolysis and hemostasis in twenty-two patients with ICH and nine healthy controls (HC) in a single-center st... Read More about Elevated plasminogen activators are associated with hematoma progression in spontaneous intracerebral hemorrhage.

Transdermal delivery of glyceryl trinitrate: clinical applications in acute stroke (2020)
Journal Article
Appleton, J. P., Krishnan, K., & Bath, P. M. (2020). Transdermal delivery of glyceryl trinitrate: clinical applications in acute stroke. Expert Opinion on Drug Delivery, 17(3), 297-303. https://doi.org/10.1080/17425247.2020.1716727

© 2020 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Glyceryl trinitrate (GTN), a nitric oxide donor, is a candidate treatment for the management of acute stroke with hemodynamic and potential reperfusion and neuroprotective... Read More about Transdermal delivery of glyceryl trinitrate: clinical applications in acute stroke.

Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis (2020)
Journal Article
Benfield, J. K., Everton, L. F., Bath, P. M., & England, T. J. (2020). Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis. Journal of Clinical Nursing, 29(9-10), 1527-1538. https://doi.org/10.1111/jocn.15192

Introduction Nurses and other nonspecialists in dysphagia are often trained to screen swallowing poststroke. There are many basic tools that test water only, they are usually conservative, and patients that fail the test remain nil by mouth until... Read More about Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis.

Endothelial progenitor cells, potential biomarkers for diagnosis and prognosis of ischemic stroke: protocol for an observational case-control study (2020)
Journal Article
Othman, O., Rakkar, K., Sprigg, N., Bath, P., & Bayraktutan, U. (2020). Endothelial progenitor cells, potential biomarkers for diagnosis and prognosis of ischemic stroke: protocol for an observational case-control study. Neural Regeneration Research, 15(7), 1300-1307. https://doi.org/10.4103/1673-5374.269028

Ischemic stroke is a devastating, life altering event which can severely reduce patient quality of life. Despite years of research there have been minimal therapeutic advances. Endothelial progenitor cells (EPCs), stem cells involved in both vasculog... Read More about Endothelial progenitor cells, potential biomarkers for diagnosis and prognosis of ischemic stroke: protocol for an observational case-control study.

The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review (2019)
Journal Article
Bath, P. M., Appleton, J. P., & England, T. (2020). The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review. JAMA Neurology, 77(1), 114-124. https://doi.org/10.1001/jamaneurol.2019.4107

Importance: While there are a limited number of beneficial treatments for acute stroke (eg, stroke units, reperfusion, aspirin, hemicraniectomy), there are more negative (as opposed to neutral) interventions spanning multiple different mechanisms of... Read More about The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review.

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), 3064-3071. 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.

Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization (2019)
Journal Article
Brainin, M., Feigin, V., Bath, P. M., Collantes, E., Martins, S., Pandian, J., …Teuschl, Y. (2019). Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization. International Journal of Stroke, 14(8), 818-825. https://doi.org/10.1177/1747493019873706

The increasing burden of stroke and dementia emphasizes the need for new, well-tolerated and cost-effective primary prevention strategies that can reduce the risks of stroke and dementia worldwide, and specifically in low- and middle-income countries... Read More about Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization.

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. https://doi.org/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 spontaneous... 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. https://doi.org/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.

The effectiveness and safety of anti-fibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 3; peer review: 2 approved] (2019)
Journal Article
Ker, K., Prieto-Merino, D., Sprigg, N., Mahmood, A., Bath, P., Kang Law, Z., …Roberts, I. (2019). The effectiveness and safety of anti-fibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 3; peer review: 2 approved]. Wellcome Open Research, Article 120. https://doi.org/10.12688/wellcomeopenres.13262.3

Introduction: The Anti-fibrinolytics Trialists Collaboration aims to increase knowledge about the effectiveness and safety of anti-fibrinolytic treatment by conducting individual patient data (IPD) meta-analyses of randomised trials. This article pre... Read More about The effectiveness and safety of anti-fibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 3; peer review: 2 approved].

Antiplatelet Therapy After Noncardioembolic Stroke: An Individual Patient Data Network Meta-Analysis (2019)
Journal Article
Greving, J. P., Diener, H., Reitsma, J., Bath, P., Csiba, L., Hacke, W., …Algra, A. (2019). Antiplatelet Therapy After Noncardioembolic Stroke: An Individual Patient Data Network Meta-Analysis. Stroke, 50(7), 1812-1818. https://doi.org/10.1161/strokeaha.118.024497

© 2019 American Heart Association, Inc. Background and Purpose-We assessed the efficacy and safety of antiplatelet agents after noncardioembolic stroke or transient ischemic attack and examined how these vary according to patients' demographic and cl... Read More about Antiplatelet Therapy After Noncardioembolic Stroke: An Individual Patient Data Network Meta-Analysis.

Outcome Assessment by Central Adjudicators Versus Site Investigators in Stroke Trials: A Systematic Review and Meta-Analysis (2019)
Journal Article
Godolphin, P. J., Bath, P. M., Algra, A., Berge, E., Brown, M. M., Chalmers, J., …on behalf of the Adjudicating Outcomes in Stroke Trials Collaboration*. (2019). Outcome Assessment by Central Adjudicators Versus Site Investigators in Stroke Trials: A Systematic Review and Meta-Analysis. Stroke, 50(8), 2187-2196. https://doi.org/10.1161/strokeaha.119.025019

© 2019 American Heart Association, Inc. Background and Purpose-In randomized stroke trials, central adjudication of a trial's primary outcome is regularly implemented. However, recent evidence questions the importance of central adjudication in rando... Read More about Outcome Assessment by Central Adjudicators Versus Site Investigators in Stroke Trials: A Systematic Review and Meta-Analysis.

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.

Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review (2019)
Journal Article
Krishnan, K., Bassilious, K., Eriksen, E., Bath, P. M., Sprigg, N., Brækken, S. K., …Sandset, E. C. (2019). Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review. European Stroke Journal, 4(3), 233-239. https://doi.org/10.1177/2396987319843701

Purpose Acute vestibular syndrome – vertigo, nausea/vomiting, nystagmus and gait unsteadiness – is common, and differentiating posterior circulation stroke from a peripheral cause can be challenging. The National Institute of Health Stroke Scale (NI... Read More about Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review.

Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry (2019)
Journal Article
S Anderson, C., Robinson, T. G., Bray, B. D., Paley, L., Sprigg, N., Wang, X., …for the ENCHANTED Investigators and the SSNAP Collaboration. (2019). Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry. International Journal of Stroke, 14(7), 678-685. https://doi.org/10.1177/1747493019841246

© 2019 World Stroke Organization. Background: Randomized controlled trials provide high-level evidence, but the necessity to include selected patients may limit the generalisability of their results. Methods: Comparisons were made of baseline and out... Read More about Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry.

14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy: proceedings and summary of discussions (2019)
Journal Article
Sheth, S. A., Lopez-Rivera, V., Lee, S., Savitz, S. I., Liebeskind, D. S., Grotta, J. C., …Bath, P. (2019). 14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy: proceedings and summary of discussions. International Journal of Stroke, 14(4), 439-441. https://doi.org/10.1177/1747493019838760

The 14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy (TTST) took place in Houston, Texas on 21–22 October 2018. Attended by 150þ invited global experts, the objectives of TTST 2018 were to explore the changing lands... Read More about 14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy: proceedings and summary of discussions.

Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion (2019)
Journal Article
Sasegbon, A., Watanabe, M., Simons, A., Michou, E., Vasant, D. H., Magara, J., …Hamdy, S. (2019). Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion. Journal of Physiology, 597(9), 2533-2546. https://doi.org/10.1113/jp277545

Repetitive transcranial magnetic stimulation (rTMS) can alter neuronal activity within the brain with therapeutic potential. Low frequency stimulation to the ‘dominant’ cortical swallowing projection induces a ‘virtual‐lesion’ transiently suppressing... Read More about Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion.

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. https://doi.org/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.

Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international randomised, open-label, blinded-endpoint phase 3 trial (2019)
Journal Article
Anderson, C. S., Huang, Y., Lindley, R. I., Chen, X., Arima, H., Chen, G., …ENCHANTED Investigators and Coordinators. (2019). Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international randomised, open-label, blinded-endpoint phase 3 trial. Lancet, 393(10174), 877-888. https://doi.org/10.1016/S0140-6736%2819%2930038-8

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., Appleton, J. P., Berge, E., Cala, L., …Mir, R. (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. https://doi.org/10.1016/S0140-6736%2819%2930194-1

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure... 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.

Short email with attachment versus long email without attachment when contacting authors to request unpublished data for a systematic review: a nested randomised trial (2019)
Journal Article
Godolphin, P. J., Bath, P. M., & Montgomery, A. A. (2019). Short email with attachment versus long email without attachment when contacting authors to request unpublished data for a systematic review: a nested randomised trial. BMJ Open, 9(1), Article e25273. https://doi.org/10.1136/bmjopen-2018-025273

Objective: Systematic reviews often rely on the acquisition of unpublished analyses or data. We carried out a nested randomised trial comparing two different approaches for contacting authors to request additional data for a systematic review. Part... Read More about Short email with attachment versus long email without attachment when contacting authors to request unpublished data for a systematic review: a nested randomised trial.

Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage (2019)
Journal Article
Pszczolkowski, S., Law, Z. K., Gallagher, R. G., Meng, D., Swienton, D. J., Morgan, P. S., …Dineen, R. A. (2019). Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage. Computers in Biology and Medicine, 106, 126-139. https://doi.org/10.1016/j.compbiomed.2019.01.022

Background Spontaneous intracerebral haemorrhage (SICH) is a common condition with high morbidity and mortality. Segmentation of haematoma and perihaematoma oedema on medical images provides quantitative outcome measures for clinical trials and may... Read More about Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage.

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), 405-412. https://doi.org/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.

Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study (2019)
Journal Article
Steele, C. M., Mukherjee, R., Kortelainen, J. M., Pölönen, H., Jedwab, M., Brady, S. L., …Muehlemann, N. (2019). Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study. Dysphagia, 34(5), 698-707. https://doi.org/10.1007/s00455-018-09974-5

Oropharyngeal dysphagia is prevalent in several at-risk populations, including post-stroke patients, patients in intensive care and the elderly. Dysphagia contributes to longer hospital stays and poor outcomes, including pneumonia. Early identificati... Read More about Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study.

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
Bath, P. M., Scutt, P., Appleton, J. P., Dixon, M., Woodhouse, L. J., Wardlaw, J. 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.

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), Article e0208142. https://doi.org/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).

Central masked adjudication of stroke diagnosis at trial entry offered no advantage over diagnosis by local clinicians: secondary analysis and simulation (2018)
Journal Article
Godolphin, P., Hepburn, T., Sprigg, N., Walker, L., Berge, E., Collins, R., …Montgomery, A. (2018). Central masked adjudication of stroke diagnosis at trial entry offered no advantage over diagnosis by local clinicians: secondary analysis and simulation. Contemporary Clinical Trials Communications, 12, 176-181. https://doi.org/10.1016/j.conctc.2018.11.002

Background Central adjudication of stroke type is commonly implemented in large multicentre clinical trials. We investigated the effect of central adjudication of diagnosis of stroke type at trial entry in the Efficacy of Nitric Oxide in Stroke (E... Read More about Central masked adjudication of stroke diagnosis at trial entry offered no advantage over diagnosis by local clinicians: secondary analysis and simulation.

Action Plan for Stroke in Europe 2018–2030 (2018)
Journal Article
Norrving, B., Barrick, J., Davalos, A., Dichgans, M., Cordonnier, C., Guekht, A., …Caso, V. (2018). Action Plan for Stroke in Europe 2018–2030. European Stroke Journal, 3(4), 309-336. https://doi.org/10.1177/2396987318808719

Two previous pan-European consensus meetings, the 1995 and 2006 Helsingborg meetings, were convened to review the scientific evidence and the state of current services to identify priorities for research and development and to set targets for the dev... Read More about Action Plan for Stroke in Europe 2018–2030.

Acute treatment of stroke (except thrombectomy) (2018)
Journal Article
Venturelli, P. M., Appleton, J. P., Anderson, C. S., & Bath, P. M. (2018). Acute treatment of stroke (except thrombectomy). Current Neurology and Neuroscience Reports, 18(11), doi:10.1007/s11910-018-0883-x

Purpose of Review: The management of patients with acute stroke has been revolutionized in recent years with the advent of new effective treatments. In this rapidly evolving field, we provide an update on the management of acute stroke excluding thro... Read More about Acute treatment of stroke (except thrombectomy).

Impact of hydration status on haemodynamics, effects of acute blood pressure lowering treatment, and prognosis after stroke (2018)
Journal Article
Billington, C. K., Appleton, J. P., Berge, E., Sprigg, N., Glover, M., & Bath, P. M. (2018). Impact of hydration status on haemodynamics, effects of acute blood pressure lowering treatment, and prognosis after stroke. British Journal of Clinical Pharmacology, 84(12), 2914-2922. https://doi.org/10.1111/bcp.13761

Background High blood pressure (BP) is common in acute stroke and associated with poor outcome, but the Efficacy of Nitric Oxide in Stroke (ENOS) trial showed no beneficial effect of antihypertensive treatment in this situation. Antihypertensive a... Read More about Impact of hydration status on haemodynamics, effects of acute blood pressure lowering treatment, and prognosis after stroke.

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), 1-75. https://doi.org/10.3310/hta22480

© Queen’s Printer and Controller of HMSO 2018. 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... Read More about Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: The TARDIS RCT.

Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomised trial (2018)
Journal Article
Dziewas, R., Stellato, R., Van Der Tweel, I., Walther, E., Werner, C. J., Braun, T., …Bath, P. M. (2018). Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomised trial. Lancet Neurology, 17(10), 849-859. https://doi.org/10.1016/S1474-4422%2818%2930255-2

Background Dysphagia after stroke is common, especially in severely affected, tracheotomised patients. In a pilot trial, pharyngeal electrical stimulation (PES) improved swallowing function in this group of patients. The PHAryngeal electrical STi... Read More about Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomised 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.

Does therapy with biofeedback improve swallowing in adults with dysphagia?: a systematic review and meta-analysis (2018)
Journal Article
Benfield, J. K., Everton, L. F., Bath, P. M., & England, T. J. (in press). Does therapy with biofeedback improve swallowing in adults with dysphagia?: a systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, https://doi.org/10.1016/j.apmr.2018.04.031

Objective To describe and systematically review the current evidence on the effects of swallow therapy augmented by biofeedback in adults with dysphagia (PROSPERO 2016:CRD42016052942). Data sources Two independent reviewers conducted searches whic... Read More about Does therapy with biofeedback improve swallowing in adults with dysphagia?: a systematic review and meta-analysis.

Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial (2018)
Journal Article
Sprigg, N., Flaherty, K., Appleton, J. P., Al-Shahi Salman, R., Bereczki, D., Beridze, M., …Bath, P. M. (2018). Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet, 391(10135), 2107-2115. https://doi.org/10.1016/S0140-6736%2818%2931033-X

Background Tranexamic acid (TXA) reduces death due to bleeding after trauma and post-partum haemorrhage. The aim was to assess if tranexamic acid reduces haematoma expansion and improves outcome in adults with stroke due to intracerebral 6 haemorrha... Read More about Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial.

Small vessels, dementia and chronic diseases – molecular mechanisms and pathophysiology (2018)
Journal Article
Horsburgh, K., Wardlaw, J. M., van Agtmael, T., Allan, S. M., Ashford, M. L., Bath, P. M., …Work, L. M. (2018). Small vessels, dementia and chronic diseases – molecular mechanisms and pathophysiology. Clinical Science, 132(8), https://doi.org/10.1042/CS20171620

Cerebral small vessel disease (SVD) is a major contributor to stroke, cognitive impairment and dementia with limited therapeutic interventions. There is a critical need to provide mechanistic insight and improve translation between pre-clinical resea... Read More about Small vessels, dementia and chronic diseases – molecular mechanisms and pathophysiology.

PRECIOUS: PREvention of Complications to Improve OUtcome in elderly patients with acute Stroke: rationale and design of a randomised, open, phase III, clinical trial with blinded outcome assessment (2018)
Journal Article
Reinink, H., de Jonge, J. C., Bath, P. M., van de Beek, D., Berge, E., Borregaard, S., …van der Worp, B. (in press). PRECIOUS: PREvention of Complications to Improve OUtcome in elderly patients with acute Stroke: rationale and design of a randomised, open, phase III, clinical trial with blinded outcome assessment. European Stroke Journal, https://doi.org/10.1186/ISRCTN82217627

Background: Elderly patients are at high risk of complications after stroke, such as infections and fever. The occurrence of these complications has been associated with an increased risk of death or dependency. Hypothesis: Prevention of aspiration,... Read More about PRECIOUS: PREvention of Complications to Improve OUtcome in elderly patients with acute Stroke: rationale and design of a randomised, open, phase III, clinical trial with blinded outcome assessment.

Lipid-lowering pretreatment and outcome following intravenous thrombolysis for acute ischaemic stroke: a post hoc analysis of the enhanced control of hypertension and thrombolysis stroke study trial (2018)
Journal Article
Minhas, J. S., Wang, X., Arima, H., Bath, P. M., Billot, L., Broderick, J. P., …Robinson, T. G. (in press). Lipid-lowering pretreatment and outcome following intravenous thrombolysis for acute ischaemic stroke: a post hoc analysis of the enhanced control of hypertension and thrombolysis stroke study trial. Cerebrovascular Diseases, 45(5-6), https://doi.org/10.1159/000488911

Background: Debate exists as to whether statin pretreatment confers an increased risk of 90-day mortality and symptomatic intracranial haemorrhage (sICH) in acute ischaemic stroke (AIS) patients treated with intravenous thrombolysis. We assessed the... Read More about Lipid-lowering pretreatment and outcome following intravenous thrombolysis for acute ischaemic stroke: a post hoc analysis of the enhanced control of hypertension and thrombolysis stroke study trial.

Haemostatic therapies for acute spontaneous intracerebral haemorrhage (2018)
Journal Article
Al-Shahi Salman, R., Law, Z. K., Bath, P. M., Steiner, T., & Sprigg, N. (2018). Haemostatic therapies for acute spontaneous intracerebral haemorrhage. Cochrane Database of Systematic Reviews, Article CD005951. https://doi.org/10.1002/14651858.CD005951.pub4

Background: Outcome after spontaneous (non-traumatic) intracerebral haemorrhage (ICH) is influenced by haematoma volume; up to one-third of ICHs enlarge within 24 hours of onset. Early haemostatic therapy might improve outcome by limiting haematoma g... Read More about Haemostatic therapies for acute spontaneous intracerebral haemorrhage.

Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel and prasugrel, and bleeding disorders (2018)
Journal Article
Bath, P. M., May, J., & Heptinstall, S. (2018). Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel and prasugrel, and bleeding disorders. Platelets, 29(5), 425-430. https://doi.org/10.1080/09537104.2018.1445839

Vascular diseases such as myocardial infarction and ischaemic stroke are associated with increased platelet function whilst the risk of recurrence is reduced by antiplatelet agents such as aspirin, clopidogrel and prasugrel. However, some patients ex... Read More about Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel and prasugrel, and bleeding disorders.

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].

Statistical analysis plan for the ‘Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2)’ (2018)
Journal Article
Scutt, P., Appleton, J. P., Dixon, M., Woodhouse, L. J., Sprigg, N., Wardlaw, J. M., …Bath, P. M. (2018). Statistical analysis plan for the ‘Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2)’. European Stroke Journal, 3(2), 193-196. https://doi.org/10.1177/2396987318756696

Rationale: Glyceryl trinitrate, a nitric oxide donor, is a candidate treatment for acute stroke; it lowers blood pressure, does not alter cerebral blood flow or platelet function and is neuroprotective in experimental stroke. The ongoing rapid interv... Read More about Statistical analysis plan for the ‘Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2)’.

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.

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial (2017)
Journal Article
Bath, P. M., Christensen, L. M., Woodhouse, L. J., Bentsen, L., Appleton, J. P., Krarup Hansen, C., …Farren, P. (2018). Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial. Lancet, 391(10123), 850-859. https://doi.org/10.1016/S0140-6736%2817%2932849-0

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplat... Read More about Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial.

Statistical analysis plan for the EuroHYP-1 trial: European multicentre, randomised, phase III clinical trial of the therapeutic hypothermia plus best medical treatment versus best medical treatment alone for acute ischaemic stroke (2017)
Journal Article
Winkel, P., Bath, P. M., Gluud, C., Lindschou, J., van der Worp, H. B., Macleod, M. R., …Schwab, S. (in press). Statistical analysis plan for the EuroHYP-1 trial: European multicentre, randomised, phase III clinical trial of the therapeutic hypothermia plus best medical treatment versus best medical treatment alone for acute ischaemic stroke. Trials, 18(1), https://doi.org/10.1186/s13063-017-2302-z

Background: Cooling may reduce infarct size and improve neurological outcomes in patients with ischaemic stroke. In phase II trials, cooling awake patients with ischaemic stroke has been shown to be feasible and safe, but the effects in functional ou... Read More about Statistical analysis plan for the EuroHYP-1 trial: European multicentre, randomised, phase III clinical trial of the therapeutic hypothermia plus best medical treatment versus best medical treatment alone for acute ischaemic stroke.

Relationship between race and outcome in Asian, Black and Caucasian patients with spontaneous intracerebral haemorrhage: data from the Virtual International Stroke Trials Archive (VISTA) and Efficacy of Nitric Oxide in Stroke trial (ENOS) (2017)
Journal Article
Krishnan, K., Beishon, L., Berge, E., Christensen, H., Dineen, R. A., Ozturk, S., …Bath, P. M. (2018). Relationship between race and outcome in Asian, Black and Caucasian patients with spontaneous intracerebral haemorrhage: data from the Virtual International Stroke Trials Archive (VISTA) and Efficacy of Nitric Oxide in Stroke trial (ENOS). International Journal of Stroke, 13(4), https://doi.org/10.1177/1747493017744463

Background and purpose: Although poor prognosis after intracerebral haemorrhage relates to risk factors and haematoma characteristics, there is limited evidence for the effect of race-ethnicity. Methods: Data from 1011 patients with intracerebral ha... Read More about Relationship between race and outcome in Asian, Black and Caucasian patients with spontaneous intracerebral haemorrhage: data from the Virtual International Stroke Trials Archive (VISTA) and Efficacy of Nitric Oxide in Stroke trial (ENOS).

Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review (2017)
Journal Article
Armstrong, S., Langlois, A., Laparidou, D., Dixon, M., Appleton, J. P., Bath, P. M., …Siriwardena, A. N. (2017). Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review. BMC Medical Research Methodology, 17(1), Article 142. https://doi.org/10.1186/s12874-017-0423-4

Background We sought to understand the main ethical considerations when conducting clinical trials in the prehospital ambulance based setting. Methods A systematic review of the literature on randomised controlled trials in ambulance setting... Read More about Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review.

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.

The effect of different combinations of vascular, dependency and cognitive endpoints on the sample size required to detect a treatment effect in trials of treatments to improve outcome after lacunar and non-lacunar ischaemic stroke (2017)
Journal Article
Makin, S. D., Doubal, F., Quinn, T. J., Bath, P. M., Dennis, M. S., & Wardlaw, J. M. (in press). The effect of different combinations of vascular, dependency and cognitive endpoints on the sample size required to detect a treatment effect in trials of treatments to improve outcome after lacunar and non-lacunar ischaemic stroke. European Stroke Journal, 3(1), https://doi.org/10.1177/2396987317728854

Background Endpoints that are commonly used in trials of moderate/severe stroke may be less frequent in patients with minor, non-disabling stroke thus inflating sample sizes. We tested whether trial efficiency might be improved with composite endp... Read More about The effect of different combinations of vascular, dependency and cognitive endpoints on the sample size required to detect a treatment effect in trials of treatments to improve outcome after lacunar and non-lacunar ischaemic stroke.

Validating and comparing stroke prognosis scales (2017)
Journal Article
Quinn, T. J., Singh, S., Lees, K. R., Bath, P. M., & Myint, P. K. (2017). Validating and comparing stroke prognosis scales. Neurology, 89(10), https://doi.org/10.1212/WNL.0000000000004332

Objective: To compare the prognostic accuracy of various acute stroke prognostic scales using a large, independent, clinical trials dataset. Methods: We directly compared 8 stroke prognostic scales, chosen based on focused literature review (Acute... Read More about Validating and comparing stroke prognosis scales.

Predicting major bleeding in patients with noncardioembolic stroke on antiplatelets (2017)
Journal Article
Hilkens, N. A., Algra, A., Diener, H., Reitsma, J. B., Bath, P. M., Csiba, L., …Greving, J. P. (2017). Predicting major bleeding in patients with noncardioembolic stroke on antiplatelets. Neurology, 89(9), https://doi.org/10.1212/WNL.0000000000004289

Objective: To develop and externally validate a prediction model for major bleeding in patients with a TIA or ischemic stroke on antiplatelet agents. Methods: We combined individual patient data from 6 randomized clinical trials (CAPRIE, ESPS-2, M... Read More about Predicting major bleeding in patients with noncardioembolic stroke on antiplatelets.

Infections up to 76 days after stroke increase disability and death (2017)
Journal Article
Learoyd, A., Woodhouse, L. J., Shaw, L., Sprigg, N., Bereczki, D., Berge, E., …Trueman, R. C. (in press). Infections up to 76 days after stroke increase disability and death. Translational Stroke Research, https://doi.org/10.1007/s12975-017-0553-3

Early infection after stroke is associated with a poor outcome. We aimed to determine whether delayed infections (up to 76 days post-stroke) are associated with poor outcome at 90 days. Data came from the international Efficacy of Nitric Oxide Stroke... Read More about Infections up to 76 days after stroke increase disability and death.

Remote assessment of platelet function in patients with acute stroke or transient ischaemic attack (2017)
Journal Article
Bath, P. M., May, J., Flaherty, K., Woodhouse, L. J., Dovlatova, N., Fox, S. C., …TARDIS Investigators. (2017). Remote assessment of platelet function in patients with acute stroke or transient ischaemic attack. Stroke Research and Treatment, 2017, Article 7365684. https://doi.org/10.1155/2017/7365684

Background: Antiplatelets reduce recurrence after cerebral ischaemia. The international TARDIS trial assessed the safety and efficacy of intensive (combined aspirin, dipyridamole and clopidogrel) versus guideline (aspirin and dipyridamole, or clopido... Read More about Remote assessment of platelet function in patients with acute stroke or transient ischaemic attack.

Cerebral misery perfusion due to carotid occlusive disease (2017)
Journal Article
Maddula, M., Sprigg, N., Bath, P. M., & Munshi, S. K. (in press). Cerebral misery perfusion due to carotid occlusive disease. Stroke and Vascular Neurology, Article e000067. https://doi.org/10.1136/svn-2017-000067

Purpose Cerebral misery perfusion (CMP) is a condition where cerebral autoregulatory capacity is exhausted, and cerebral blood supply in insufficient to meet metabolic demand. We present an educational review of this important condition, which has a... Read More about Cerebral misery perfusion due to carotid occlusive disease.

The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden (2017)
Journal Article
Ban, L., Abdul Sultan, A., Stephansson, O., Tata, L. J., Sprigg, N., Nelson-Piercy, C., …Ludvigsson, J. F. (2017). The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden. European Stroke Journal, 2(3), 250-256. https://doi.org/10.1177/2396987317706600

Introduction: Research has suggested that delivery is associated with an increased risk of stroke in women; however, there is a lack of contemporary estimates on the incidence of stroke in and after pregnancy compared with the baseline risk in women... Read More about The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden.

The incidence of first stroke in pregnant and non-pregnant women of childbearing age: a population-based cohort study from England (2017)
Journal Article
Ban, L., Sprigg, N., Nelson-Piercy, C., Bath, P. M., Ludvigsson, J. F., Stephansson, O., & Tata, L. J. (2017). The incidence of first stroke in pregnant and non-pregnant women of childbearing age: a population-based cohort study from England. Journal of the American Heart Association, 6(4), Article e004601. https://doi.org/10.1161/JAHA.116.004601

Background: Pregnant women may have an increased risk of stroke compared to non-pregnant women of similar age, but the magnitude and the timing of such risk are unclear. We examined the risk of first stroke event in women of childbearing age and comp... Read More about The incidence of first stroke in pregnant and non-pregnant women of childbearing age: a population-based cohort study from England.

Nitric oxide donors (nitrates), L-arginine, or nitric oxide synthase inhibitors for acute stroke (2017)
Journal Article
Bath, P. M., Krishnan, K., & Appleton, J. P. (in press). Nitric oxide donors (nitrates), L-arginine, or nitric oxide synthase inhibitors for acute stroke. Cochrane Database of Systematic Reviews, Article CD000398. https://doi.org/10.1002/14651858.CD000398.pub2

Background:Nitric oxide (NO) has multiple effects that may be beneficial in acute stroke, including lowering blood pressure, and promoting reperfusion and cytoprotection. Some forms of nitric oxide synthase inhibition (NOS-I) may also be beneficial.... Read More about Nitric oxide donors (nitrates), L-arginine, or nitric oxide synthase inhibitors for acute stroke.

Interruption to antiplatelet therapy early after acute ischaemic stroke: a nested case-control study (2017)
Journal Article
Mazlan-Kepli, W., Macisaac, R. L., Walters, M., Bath, P. M. W., & Dawson, J. (2017). Interruption to antiplatelet therapy early after acute ischaemic stroke: a nested case-control study. British Journal of Clinical Pharmacology, 83(9), https://doi.org/10.1111/bcp.13290

Aims: Antiplatelet drugs are often discontinued early after ischaemic stroke, either because of poor compliance, complications or withdrawal of care. It is unclear whether this places patients at increased risk of recurrence. We explored the associat... Read More about Interruption to antiplatelet therapy early after acute ischaemic stroke: a nested case-control study.

Remote Ischaemic Conditioning after Stroke Trial (RECAST): a pilot randomised placebo controlled phase II trial in acute ischaemic stroke (ISRCTN 86672015) (2017)
Journal Article
England, T. J., Hedstrom, A., O'Sullivan, S., Donnelly, R., Barrett, D. A., Sarmad, S., …Bath, P. M. (2017). Remote Ischaemic Conditioning after Stroke Trial (RECAST): a pilot randomised placebo controlled phase II trial in acute ischaemic stroke (ISRCTN 86672015). Stroke, 48(5), https://doi.org/10.1161/STROKEAHA.116.016429

Background: Repeated episodes of limb ischaemia and reperfusion (remote ischaemic conditioning, RIC) may improve outcome after acute stroke. Methods: We performed a pilot blinded placebo-controlled trial in patients with acute ischaemic stroke, ra... Read More about Remote Ischaemic Conditioning after Stroke Trial (RECAST): a pilot randomised placebo controlled phase II trial in acute ischaemic stroke (ISRCTN 86672015).

Magnetic resonance imaging plaque hemorrhage for risk stratification in carotid artery disease with moderate risk under current medical therapy (2017)
Journal Article
Hosseini, A. A., Simpson, R. J., Altaf, N., Bath, P. M., MacSweeney, S. T., & Auer, D. P. (2017). Magnetic resonance imaging plaque hemorrhage for risk stratification in carotid artery disease with moderate risk under current medical therapy. Stroke, 48(3), https://doi.org/10.1161/STROKEAHA.116.015504

Background and Purpose—Magnetic resonance imaging (MRI)–defined carotid plaque hemorrhage (MRIPH) can predict recurrent cerebrovascular ischemic events in severe symptomatic carotid stenosis. It is less clear whether MRIPH can improve risk stratifica... Read More about Magnetic resonance imaging plaque hemorrhage for risk stratification in carotid artery disease with moderate risk under current medical therapy.

Investigating the effect of independent blinded digital image assessment on the STOP GAP trial (2017)
Journal Article
Patsko, E., Godolphin, P. J., Thomas, K. S., Hepburn, T., Mitchell, E., Craig, F. E., …Montgomery, A. A. (2017). Investigating the effect of independent blinded digital image assessment on the STOP GAP trial. Trials, 18(1), Article 53. https://doi.org/10.1186/s13063-017-1779-9

Background Blinding is the process of keeping treatment assignment hidden and is used to minimise the possibility of bias. Trials at high risk of bias have been shown to report larger treatment effects than low risk studies. In dermatology, one popu... Read More about Investigating the effect of independent blinded digital image assessment on the STOP GAP trial.

Intensive versus guideline blood pressure and lipid lowering in patients with previous stroke: main results from the pilot ‘Prevention of decline in cognition after stroke trial’ (PODCAST) randomised controlled trial (2017)
Journal Article
Bath, P. M., Scutt, P., Blackburn, D. J., Ankolekar, S., Krishnan, K., Ballard, C., …Ford, G. A. (2017). Intensive versus guideline blood pressure and lipid lowering in patients with previous stroke: main results from the pilot ‘Prevention of decline in cognition after stroke trial’ (PODCAST) randomised controlled trial. PLoS ONE, 12(1), Article e0164608. https://doi.org/10.1371/journal.pone.0164608

Background Stroke is associated with the development of cognitive impairment and dementia. We assessed the effect of intensive blood pressure (BP) and/or lipid lowering on cognitive outcomes in patients with recent stroke in a pilot trial. Meth... Read More about Intensive versus guideline blood pressure and lipid lowering in patients with previous stroke: main results from the pilot ‘Prevention of decline in cognition after stroke trial’ (PODCAST) randomised controlled trial.

Understanding the relationship between costs and the modified Rankin Scale: a systematic review, multidisciplinary consensus and recommendations for future studies (2016)
Journal Article
Wilson, A., Bath, P. M., Berge, E., Cadilhac, D. A., Cuche, M., Ford, G. A., …Lees, K. R. (2017). Understanding the relationship between costs and the modified Rankin Scale: a systematic review, multidisciplinary consensus and recommendations for future studies. European Stroke Journal, 2(1), https://doi.org/10.1177/2396987316684705

Background and purpose: Cost-of-illness studies often describe a single aggregate cost of a disease state. This approach is less helpful for a condition with a spectrum of outcomes like stroke. The modified Rankin Scale is the most commonly used outc... Read More about Understanding the relationship between costs and the modified Rankin Scale: a systematic review, multidisciplinary consensus and recommendations for future studies.

Dependency and health utilities in stroke: data to inform cost-effectiveness analyses (2016)
Journal Article
Ali, M., MacIsaac, R., Quinn, T. J., Bath, P. M., Veenstra, D. L., Xu, Y., …Lees, K. R. (2017). Dependency and health utilities in stroke: data to inform cost-effectiveness analyses. European Stroke Journal, 2(1), https://doi.org/10.1177/2396987316683780

Introduction: Health utilities (HU) assign preference weights to specific health states and are required for costeffectiveness analyses. Existing HU for stroke inadequately reflect the spectrum of post-stroke disability. Using international stroke tr... Read More about Dependency and health utilities in stroke: data to inform cost-effectiveness analyses.

Antiplatelet therapy following ischaemic stroke: continue or change pre-existing therapy? (2016)
Journal Article
Mazlan-Kepli, W., MacIsaac, R. L., Walters, M., Bath, P. M., & Dawson, J. (2017). Antiplatelet therapy following ischaemic stroke: continue or change pre-existing therapy?. European Stroke Journal, 2(1), https://doi.org/10.1177/2396987316678728

Introduction: Antiplatelet therapy is routinely prescribed early after ischaemic stroke. Many patients will already be taking antiplatelet therapy and it is unknown whether these patients should continue the same antiplatelet treatment or switch to a... Read More about Antiplatelet therapy following ischaemic stroke: continue or change pre-existing therapy?.

Baseline characteristics of the 3,096 patients recruited into the 'Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke' (TARDIS) trial (2016)
Journal Article
Bath, P. M., Appleton, J. P., Beridze, M., Christensen, H., Dineen, R. A., Duley, L., …Sprigg, N. (2017). Baseline characteristics of the 3,096 patients recruited into the 'Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke' (TARDIS) trial. International Journal of Stroke, 12(5), 524-538. https://doi.org/10.1177/1747493016677988

Background: The risk of recurrence following ischaemic stroke (IS) or transient ischaemic attack (TIA) is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in... Read More about Baseline characteristics of the 3,096 patients recruited into the 'Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke' (TARDIS) trial.

Design and implementation of Pharyngeal electrical Stimulation for early de-cannulation in TRACheotomized (PHAST-TRAC) stroke patients with neurogenic dysphagia: a prospective randomized single-blinded interventional study (2016)
Journal Article
Dziewas, R., Mistry, S., Hamdy, S., Minnerup, J., Van Der Tweel, I., Schäbitz, W., & Bath, P. M. (2017). Design and implementation of Pharyngeal electrical Stimulation for early de-cannulation in TRACheotomized (PHAST-TRAC) stroke patients with neurogenic dysphagia: a prospective randomized single-blinded interventional study. International Journal of Stroke, 12(4), https://doi.org/10.1177/1747493016676618

Rationale: Ongoing dysphagia in stroke patients weaned from mechanical ventilation often requires long-term tracheotomy to protect the airway from aspiration. In a recently reported single-centre pilot study, a significantly larger proportion (75%) o... Read More about Design and implementation of Pharyngeal electrical Stimulation for early de-cannulation in TRACheotomized (PHAST-TRAC) stroke patients with neurogenic dysphagia: a prospective randomized single-blinded interventional study.

Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730) (2016)
Journal Article
Sprigg, N., O’Connor, R., Woodhouse, L. J., Krishnan, K., England, T. J., Connell, L. A., …Bath, P. M. (2016). Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730). PLoS ONE, 11(9), Article e0161359. https://doi.org/10.1371/journal.pone.0161359

Background Granulocyte-colony stimulating factor (G-CSF) mobilises endogenous haematopoietic stem cells and enhances recovery in experimental stroke. Recovery may also be dependent on an enriched environment and physical activity. G-CSF may have the... Read More about Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730).

Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study (2016)
Journal Article
Kalladka, D., Sinden, J., Pollock, K., Haig, C., McLean, J., Smith, W., …Muir, K. W. (2016). Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study. Lancet, 388(10046), 787-796. https://doi.org/10.1016/S0140-6736%2816%2930513-X

Background: CTX0E03 is an immortalised human neural stem-cell line from which a drug product (CTX-DP) was developed for allogeneic therapy. Dose-dependent improvement in sensorimotor function in rats implanted with CTX-DP 4 weeks after middle cerebra... Read More about Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study.

The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research (2016)
Journal Article
Bath, P. M., Appleton, J. P., & Sprigg, N. (in press). The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research. International Journal of Stroke, https://doi.org/10.1177/1747493016660099

The prevention of recurrent events after ischaemic stroke and transient ischaemic attack is well established and based on lifestyle changes, antithrombotics, statins, antihypertensives and carotid surgery. The international IRIS trial assessed whethe... Read More about The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research.

Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke (2016)
Journal Article
Bath, P. M., Scutt, P., Love, J., Clavé, P., Cohen, D., Dziewas, R., …Hamdy, S. (in press). Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke. Stroke, 47(6), https://doi.org/10.1161/STROKEAHA.115.012455

Background and Purpose: Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in... Read More about Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke.

Continuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage: A Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke Trial (2016)
Journal Article
Krishnan, K., Scutt, P., Woodhouse, L., Bath, P. M., Adami, A., Becker, J. L., …Bath, P. M. (2016). Continuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage: A Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke Trial. Journal of Stroke and Cerebrovascular Diseases, 25(5), 1017-1026. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.010

Background and purpose: More than 50% of patients with acute intracerebral haemorrhage (ICH) are taking antihypertensive drugs before ictus. Although antihypertensive therapy should be given long term for secondary prevention, whether to continue or... Read More about Continuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage: A Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke Trial.

Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials (2016)
Journal Article
Bath, P. M., Woodhouse, L. J., Krishnan, K., Anderson, C., Berge, E., Ford, G. A., …Wardlaw, J. M. (2016). Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials. Stroke Research and Treatment, 2016, https://doi.org/10.1155/2016/9706720

Background. Nitric oxide (NO) donors are a candidate treatment for acute stroke and two trials have suggested that they might improve outcome if administered within 4–6 hours of stroke onset. We assessed the safety and efficacy of NO donors using ind... Read More about Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials.

Glyceryl Trinitrate for Acute Intracerebral Hemorrhage: Results From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial, a Subgroup Analysis (2015)
Journal Article
Krishnan, K., Scutt, P., Woodhouse, L. J., Adami, A., Becker, J. L., Berge, E., …Bath, P. M. (in press). Glyceryl Trinitrate for Acute Intracerebral Hemorrhage: Results From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial, a Subgroup Analysis. Stroke, 47(1), 44-52. https://doi.org/10.1161/strokeaha.115.010368

Background and purpose: The Efficacy of Nitric oxide in Stroke (ENOS) trial found that transdermal glyceryl trinitrate (GTN, a nitric oxide donor) lowered blood pressure but did not improve functional outcome in patients with acute stroke. However, G... Read More about Glyceryl Trinitrate for Acute Intracerebral Hemorrhage: Results From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial, a Subgroup Analysis.

Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST) (2015)
Journal Article
Scutt, P., Blackburn, D., Krishnan, K., Ballard, C., Burns, A., Ford, G. A., …Bath, P. M. (2015). Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST). Trials, 16(1), Article 509. https://doi.org/10.1186/s13063-015-1033-2

Background A common complication after stroke is development of cognitive impairment and dementia. However, effective strategies for reducing the risk of developing these problems remain undefined. Potential strategies include intensive lowering o... Read More about Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST).

Inhibition of TNF-? protects in vitro brain barrier from ischaemic damage (2015)
Journal Article
Abdullah, Z., Rakkar, K., Bath, P. M., & Bayraktutan, U. (2015). Inhibition of TNF-? protects in vitro brain barrier from ischaemic damage. Molecular and Cellular Neuroscience, 69, https://doi.org/10.1016/j.mcn.2015.11.003

Cerebral ischaemia, associated with neuroinflammation and oxidative stress, is known to perturb blood–brain barrier (BBB) integrity and promote brain oedema formation. Using an in vitro model of human BBB composed of brain microvascular endothelial c... Read More about Inhibition of TNF-? protects in vitro brain barrier from ischaemic damage.

Safety and efficacy of intensive vs. guideline antiplatelet therapy in high-risk patients with recent ischemic stroke or transient ischemic attack: rationale and design of the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial (ISRCTN47823388) (2015)
Journal Article
Beridze, M., Christensen, H., Dineen, R. A., Duley, L., Heptinstall, S., James, M., …Bath, P. M. (2015). Safety and efficacy of intensive vs. guideline antiplatelet therapy in high-risk patients with recent ischemic stroke or transient ischemic attack: rationale and design of the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial (ISRCTN47823388). International Journal of Stroke, 10(7), https://doi.org/10.1111/ijs.12538

RATIONALE: The risk of recurrence following a stroke or transient ischemic attack is high, especially immediately after the event. HYPOTHESIS: Because two antiplatelet agents are superior to one in patients with non-cardioembolic events, more... Read More about Safety and efficacy of intensive vs. guideline antiplatelet therapy in high-risk patients with recent ischemic stroke or transient ischemic attack: rationale and design of the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial (ISRCTN47823388).

Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions (2015)
Journal Article
Bath, P. M., & Wardlaw, J. M. (2015). Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions. International Journal of Stroke, 10(4), https://doi.org/10.1111/ijs.12466

Small vessel disease encompasses lacunar stroke, white matter hyperintensities, lacunes and microbleeds. It causes a quarter of all ischemic strokes, is the commonest cause of vascular dementia, and the cause is incompletely understood. Vascular prop... Read More about Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions.

Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial (2015)
Journal Article
Krishnan, K., Mukhtar, S. F., Dineen, R., Lingard, J., Houlton, A., Walker, E., …Wardlaw, J. M. (2015). Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial. Journal of Neurology, Neurosurgery and Psychiatry, 86(11), 1258-1266. https://doi.org/10.1136/jnnp-2014-309845

Background: Poor prognosis after intracerebral haemorrhage (ICH) is related to haemorrhage characteristics. Along with developing therapeutic interventions, we sought to understand the performance of haemorrhage descriptors in large clinical trials.... Read More about Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial.

Pharyngeal electrical stimulation for treatment of poststroke dysphagia: individual patient data meta-analysis of randomised controlled trials (2015)
Journal Article
Scutt, P., Lee, H. S., Hamdy, S., & Bath, P. M. (2015). Pharyngeal electrical stimulation for treatment of poststroke dysphagia: individual patient data meta-analysis of randomised controlled trials. Stroke Research and Treatment, 2015, Article 429053. https://doi.org/10.1155/2015/429053

Background. Dysphagia after stroke is common, associated independently with poor outcome, and has limited treatment options. Pharyngeal electrical stimulation (PES) is a novel treatment being evaluated for treatment of poststroke dysphagia. Methods.... Read More about Pharyngeal electrical stimulation for treatment of poststroke dysphagia: individual patient data meta-analysis of randomised controlled trials.

Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial (2014)
Journal Article
Bath, P. M., Robson, K., Woodhouse, L. J., Sprigg, N., Dineen, R. A., & Pocock, S. J. (2015). Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial. International Journal of Stroke, 10(3), https://doi.org/10.1111/ijs.12445

Rationale: Antiplatelet agents such as aspirin, clopidogrel and dipyridamole are effective in reducing the risk of recurrence after a stroke. Importantly, the risk of recurrence is highest immediately after the index event while antiplatelets cause b... Read More about Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial.

Interventions for deliberately altering blood pressure in acute stroke (2014)
Journal Article
Bath, P. M., & Krishnan, K. (2014). Interventions for deliberately altering blood pressure in acute stroke. Cochrane Database of Systematic Reviews, 2014(10), Article CD000039. https://doi.org/10.1002/14651858.CD000039.pub3

Background: It is unclear whether blood pressure should be altered actively during the acute phase of stroke. This is an update of a Cochrane review first published in 1997, and previously updated in 2001 and 2008. Objectives: To assess the clinical... Read More about Interventions for deliberately altering blood pressure in acute stroke.

Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial (2014)
Journal Article
Bath, P. M. (2015). Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial. Lancet, 385(9968), https://doi.org/10.1016/S0140-6736%2814%2961121-1

Background High blood pressure is associated with poor outcome after stroke. Whether blood pressure should be lowered early after stroke, and whether to continue or temporarily withdraw existing antihypertensive drugs, is not known. We assessed ou... Read More about Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial.

Testing devices for the prevention and treatment of stroke and its complications (2014)
Journal Article
Bath, P. M., Brainin, M., Brown, C., Campbell, B., Davis, S. M., Donnan, G. A., …Truelsen, T. (in press). Testing devices for the prevention and treatment of stroke and its complications. International Journal of Stroke, 9(6), https://doi.org/10.1111/ijs.12302

We are entering a challenging but exciting period when many new interventions may appear for stroke based on the use of devices. Hopefully these will lead to improved outcomes at a cost that can be afforded in most parts of the world. Nevertheless, i... Read More about Testing devices for the prevention and treatment of stroke and its complications.

Relationship between Poststroke Cognition, Baseline Factors, and Functional Outcome: Data from “Efficacy of Nitric Oxide in Stroke” Trial (2014)
Journal Article
Ankolekar, S., Renton, C., Sare, G., Ellender, S., Sprigg, N., Wardlaw, J. M., & Bath, P. M. (2014). Relationship between Poststroke Cognition, Baseline Factors, and Functional Outcome: Data from “Efficacy of Nitric Oxide in Stroke” Trial. Journal of Stroke and Cerebrovascular Diseases, 23(7), 1821-1829. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.022

Tranexamic Acid for Spontaneous Intracerebral Hemorrhage: A Randomized Controlled Pilot Trial (ISRCTN50867461) (2014)
Journal Article
Sprigg, N., Renton, C. J., Dineen, R. A., Kwong, Y., & Bath, P. M. (2014). Tranexamic Acid for Spontaneous Intracerebral Hemorrhage: A Randomized Controlled Pilot Trial (ISRCTN50867461). Journal of Stroke and Cerebrovascular Diseases, 23(6), 1312-1318. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.007

Background: Spontaneous intracerebral hemorrhage (ICH) can be devastating, particularly if hematoma expansion (HE) occurs. Tranexamic acid (TA), an antifibrinolytic drug, significantly reduced mortality in bleeding patients after trauma in the large... Read More about Tranexamic Acid for Spontaneous Intracerebral Hemorrhage: A Randomized Controlled Pilot Trial (ISRCTN50867461).

Statistical analysis plan for the ‘Efficacy of Nitric Oxide in Stroke’ (ENOS) trial (2014)
Journal Article
Bath, P. M., Houlton, A., Woodhouse, L. J., Sprigg, N., Wardlaw, J. M., & Pocock, S. J. (in press). Statistical analysis plan for the ‘Efficacy of Nitric Oxide in Stroke’ (ENOS) trial. International Journal of Stroke, 9(3), https://doi.org/10.1111/ijs.12235

High blood pressure is common during the acute phase of stroke and is associated with a poor outcome. However, the management of high blood pressure remains unclear. The ‘Efficacy of Nitric Oxide in Stroke’ trial tested whether transdermal glyceryl t... Read More about Statistical analysis plan for the ‘Efficacy of Nitric Oxide in Stroke’ (ENOS) trial.

Effect of telmisartan on functional outcome, recurrence, and blood pressure in patients with acute mild ischemic stroke: a PRoFESS subgroup analysis (2009)
Journal Article
Bath, P. M., Martin, R. H., Palesch, Y., Cotton, D., Yusuf, S., Sacco, R. L., …Roberts, R. (2009). Effect of telmisartan on functional outcome, recurrence, and blood pressure in patients with acute mild ischemic stroke: a PRoFESS subgroup analysis. Stroke, 40(11), 3541-3546. https://doi.org/10.1161/strokeaha.109.555623

Background and Purpose: High blood pressure (BP) is common in acute ischemic stroke and associated independently with a poor functional outcome. However, the management of BP acutely remains unclear because no large trials have been completed. Metho... Read More about Effect of telmisartan on functional outcome, recurrence, and blood pressure in patients with acute mild ischemic stroke: a PRoFESS subgroup analysis.

Granulocyte-colony stimulating factor in experimental stroke and its effects on infarct size and functional outcome: a systematic review (2009)
Journal Article
England, T. J., Gibson, C. L., & Bath, P. M. (2009). Granulocyte-colony stimulating factor in experimental stroke and its effects on infarct size and functional outcome: a systematic review. Brain Research, 62(1), 71-82. https://doi.org/10.1016/j.brainresrev.2009.09.002

Background: Granulocyte-colony stimulating factor (G-CSF) shows promise as a treatment for stroke. This systematic review assesses G-CSF in experimental ischaemic stroke. Methods: Relevant studies were identified with searches of Medline, Embase and... Read More about Granulocyte-colony stimulating factor in experimental stroke and its effects on infarct size and functional outcome: a systematic review.

Relationship between therapeutic changes in blood pressure and outcomes in acute stroke: a metaregression (2009)
Journal Article
Geeganage, C., & Bath, P. M. (in press). Relationship between therapeutic changes in blood pressure and outcomes in acute stroke: a metaregression. Hypertension, 54(4), https://doi.org/10.1161/hypertensionaha.109.133538

Both low and high blood pressure (BP) during the acute phase of stroke are associated independently with a poor outcome. Several small clinical trials have involved the alteration of BP and this study assessed the relationship between change in BP an... Read More about Relationship between therapeutic changes in blood pressure and outcomes in acute stroke: a metaregression.

Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration (2009)
Journal Article
Sare, G. M., Ali, M., Shuaib, A., & Bath, P. M. (2009). Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration. Stroke, 40(6), https://doi.org/10.1161/STROKEAHA.108.539155

Background and Purpose—High blood pressure (BP) is associated independently with poor outcome after acute ischemic stroke, although in most analyses “baseline” BP was measured 24 hours or more postictus, and not during the hyperacute period. Methods... Read More about Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration.

Speeding stroke recovery? A systematic review of amphetamine after stroke (2009)
Journal Article
Sprigg, N., & Bath, P. M. (2009). Speeding stroke recovery? A systematic review of amphetamine after stroke. Journal of the Neurological Sciences, 285(1-2), 3-9. https://doi.org/10.1016/j.jns.2009.04.040

Introduction: The use of drugs to enhance recovery (“rehabilitation pharmacology”) has been assessed. Amphetamine can improve outcome in experimental models of stroke, and several small clinical trials have assessed its use in stroke. Methods: Elec... Read More about Speeding stroke recovery? A systematic review of amphetamine after stroke.

Good laboratory practice: preventing introduction of bias at the bench (2009)
Journal Article
Macleod, M. R., Fisher, M., O'Collins, V., Sena, E. S., Dirnagl, U., Bath, P. M., …Howells, D. W. (2009). Good laboratory practice: preventing introduction of bias at the bench. Stroke, 40(3), Article e50-e52

Background and Purpose—As a research community, we have failed to demonstrate that drugs which show substantial efficacy in animal models of cerebral ischemia can also improve outcome in human stroke. Summary of Review—Accumulating evidence sugge... Read More about Good laboratory practice: preventing introduction of bias at the bench.

The relationship between baseline blood pressure and computed tomography findings in acute stroke: data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST) (2009)
Journal Article
Sare, G. M., Bath, P. M., Gray, L. J., Moulin, T., Woimant, F., England, T., …Ringelstein, B. (2009). The relationship between baseline blood pressure and computed tomography findings in acute stroke: data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST). Stroke, 40(1), https://doi.org/10.1161/STROKEAHA.108.526665

Background and Purpose—High blood pressure (BP) is present in 80% of patients with acute ischemic stroke and is independently associated with poor outcome. There are few data examining the relationship between admission BP and acute CT findings. M... Read More about The relationship between baseline blood pressure and computed tomography findings in acute stroke: data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST).

Systematic reviews as a tool for planning and interpreting trials (2009)
Journal Article
Bath, P. M., & Gray, L. J. (2009). Systematic reviews as a tool for planning and interpreting trials. International Journal of Stroke, 4(1),

Background Systematic reviews followed by ameta-analysis are carried out in medical research to combine the results of two or more related studies. Stroke trials have struggled to show beneficial effects and meta-analysis should be used more widely... Read More about Systematic reviews as a tool for planning and interpreting trials.

Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk (2008)
Journal Article
Halkes, P., Gray, L. J., Bath, P. M., Diener, H., & Guiraud-Chaumeil, B. (2008). Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk. Journal of Neurology, Neurosurgery and Psychiatry, 79(11), https://doi.org/10.1136/jnnp.2008.143875

Objectives: Our aim was to study the effect of combination therapy with aspirin and dipyridamole (A+D) over aspirin alone (ASA) in secondary prevention after transient ischemic attack or minor stroke of presumed arterial origin and to perform subgr... Read More about Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk.

Telmisartan to Prevent Recurrent Stroke and Cardiovascular Events (2008)
Journal Article
Yusuf, S., Diener, H., Sacco, R. L., Cotton, D., Ounpuu, S., Lawton, W. A., …Yoon, B. (2008). Telmisartan to Prevent Recurrent Stroke and Cardiovascular Events. New England Journal of Medicine, 359(12), 1225-1237. https://doi.org/10.1056/nejmoa0804593

Background Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin–angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including str... Read More about Telmisartan to Prevent Recurrent Stroke and Cardiovascular Events.

Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke (2008)
Journal Article
Sacco, R. L., Diener, H., Yusuf, S., Cotton, D., Ounpuu, S., Lawton, W. A., …Yoon, B. (2008). Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke. New England Journal of Medicine, 359(12), 1238-1251. https://doi.org/10.1056/NEJMoa0805002

Background: Recurrent stroke is a frequent, disabling event after ischemic stroke. This study compared the efficacy and safety of two antiplatelet regimens — aspirin plus extended release dipyridamole (ASA–ERDP) versus clopidogrel. Methods: In this... Read More about Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke.

Use of ordinal outcomes in vascular prevention trials: comparison with binary outcomes in published trials (2008)
Journal Article
Bath, P. M., Geeganage, C., Gray, L. J., Collier, T., & Pocock, S. (2008). Use of ordinal outcomes in vascular prevention trials: comparison with binary outcomes in published trials. Stroke, 39(10), https://doi.org/10.1161/STROKEAHA.107.509893

Background and Purpose—Vascular prevention trials mostly count “yes/no” (binary) outcome events, eg, stroke/no stroke. Analysis of ordered categorical vascular events (eg, fatal stroke/nonfatal stroke/no stroke) is clinically relevant and could be... Read More about Use of ordinal outcomes in vascular prevention trials: comparison with binary outcomes in published trials.

Guidelines for management of ischaemic stroke and transient ischaemic attack 2008 (2008)
Journal Article
Ringleb, P. A., Bousser, M., Ford, G., Bath, P. M., Brainin, M., Caso, V., …Walker, M. F. (2008). Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovascular Diseases, 25(5), https://doi.org/10.1159/000131083

This article represents the update of the European Stroke Initiative Recommendations for Stroke Management. These guidelines cover both ischaemic stroke and transient ischaemic attacks, which are now considered to be a single entity. The article cove... Read More about Guidelines for management of ischaemic stroke and transient ischaemic attack 2008.

Empirical evidence of bias in the design of experimental stroke studies: a metaepidemiologic approach (2008)
Journal Article
Crossley, N. A., Sena, E. S., Goehler, J., Horn, J., van der Worp, H. B., Bath, P. M., …Dirnagl, U. (2008). Empirical evidence of bias in the design of experimental stroke studies: a metaepidemiologic approach. Stroke, 39, https://doi.org/10.1161/STROKEAHA.107.498725

Background and Purpose: At least part of the failure in the transition from experimental to clinical studies in stroke has been attributed to the imprecision introduced by problems in the design of experimental stroke studies. Using a metaepidemiolog... Read More about Empirical evidence of bias in the design of experimental stroke studies: a metaepidemiologic approach.

Stroke outcome in clinical trial patients deriving from different countries (2008)
Journal Article
Ali, M., Atula, S., Bath, P. M., Grotta, J., Hacke, W., Lyden, P. D., …Lees, K. R. (2008). Stroke outcome in clinical trial patients deriving from different countries. Stroke, 40(1), https://doi.org/10.1161/STROKEAHA.108.518035

Background and Purpose—Stroke incidence and outcome vary widely within and across geographical locations. We examined whether differences in index stroke severity, stroke risk factors, mortality, and stroke outcome across geographical locations rem... Read More about Stroke outcome in clinical trial patients deriving from different countries.

A randomised controlled trial of triple antiplatelet therapy (Aspirin, Clopidogrel and Dipyridamole) in the secondary prevention of stroke: safety, tolerability and feasibility (2008)
Journal Article
Sprigg, N., Gray, L. J., England, T. J., Wilmot, M. R., Zhao, L., Sare, G. M., & Bath, P. M. (2008). A randomised controlled trial of triple antiplatelet therapy (Aspirin, Clopidogrel and Dipyridamole) in the secondary prevention of stroke: safety, tolerability and feasibility. PLoS ONE, 3(8),

Background: Aspirin, dipyridamole and clopidogrel are effective in secondary vascular prevention. Combination therapy with three antiplatelet agents might maximise the benefit of antiplatelet treatment in the secondary prevention of ischaemic stroke.... Read More about A randomised controlled trial of triple antiplatelet therapy (Aspirin, Clopidogrel and Dipyridamole) in the secondary prevention of stroke: safety, tolerability and feasibility.

Interventions for dysphagia in acute stroke (Review) (2008)
Journal Article
Bath, P. M., Bath-Hextall, F., & Smithard, D. (2008). Interventions for dysphagia in acute stroke (Review). Cochrane Library, 2008(3), https://doi.org/10.1002/14651858.CD000323

Background It is unclear how dysphagic patients should be fed and treated after acute stroke. Objectives The objective of this review was to assess the effect of different management strategies for dysphagic stroke patients, in particular how and... Read More about Interventions for dysphagia in acute stroke (Review).

Predicting long-term outcome after acute ischemic stroke: a simple index works in patients from controlled clinical trials (2008)
Journal Article
Konig, I., Ziegler, A., Bluhmki, E., Hacke, W., Bath, P. M., Sacco, R. L., …Weimar, C. (2008). Predicting long-term outcome after acute ischemic stroke: a simple index works in patients from controlled clinical trials. Stroke,

Background and Purpose—An early and reliable prognosis for recovery in stroke patients is important for initiation of individual treatment and for informing patients and relatives. We recently developed and validated models for predicting survival a... Read More about Predicting long-term outcome after acute ischemic stroke: a simple index works in patients from controlled clinical trials.

Should data monitoring committees assess efficacy when considering safety in trails in acute stroke? (2007)
Journal Article
Bath, P. M., Gray, L. J., & Wahlgren, N. (2007). Should data monitoring committees assess efficacy when considering safety in trails in acute stroke?. International Journal of Clinical Practice, 61(10),

The primary role of a trials Data Monitoring Committee (DMC) is to ensure the safety of enrolled patients. In stroke trials, safety is monitored typically by comparing death and stroke specific events between treatment groups. DMCs may also have the... Read More about Should data monitoring committees assess efficacy when considering safety in trails in acute stroke?.

Sex differences in quality of life in stroke survivors. Data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST) (2007)
Journal Article
Gray, L. J., Sprigg, N., Bath, P. M., Boysen, G., De Deyn, P. P., Leys, D., …Ringelstein, B. (2007). Sex differences in quality of life in stroke survivors. Data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST). Stroke, 38, https://doi.org/10.1161/STROKEAHA.107.488304

Introduction: Female sex is predictive of poor functional outcome in stroke, even after correction for prognostic factors. Poor quality of life (QoL) is observed in stroke survivors, with lower scores seen in the most disabled patients. We used data... Read More about Sex differences in quality of life in stroke survivors. Data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST).

Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials (2007)
Journal Article
Bath, P. M., & Optimising Analysis of Stroke Trials Collaboration, O. (2007). Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials. Stroke, 38(6), https://doi.org/10.1161/STROKEAHA.106.474080

Background and Purpose—Most large acute stroke trials have been neutral. Functional outcome is usually analyzed usinga yes or no answer, eg, death or dependency versus independence. We assessed which statistical approaches are mostefficient in analyz... Read More about Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials.

Stroke severity, early recovery and outcome are each related with clinical classification of stroke: data from the 'Tinzaparin in Acute Ischaemic Stroke Trial (TAIST) (2007)
Journal Article
Sprigg, N., Gray, L. J., Bath, P. M., Lindenstrom, E., Boysen, G., De Deyn, P. P., …Ringelstein, B. (2007). Stroke severity, early recovery and outcome are each related with clinical classification of stroke: data from the 'Tinzaparin in Acute Ischaemic Stroke Trial (TAIST). Journal of the Neurological Sciences, 254(1-2),

Introduction: Baseline severity and clinical stroke syndrome (Oxford Community Stroke Project, OCSP) classification are predictors of outcome in stroke. We used data from the ‘Tinzaparin in Acute Ischaemic Stroke Trial’ (TAIST) to assess the relation... Read More about Stroke severity, early recovery and outcome are each related with clinical classification of stroke: data from the 'Tinzaparin in Acute Ischaemic Stroke Trial (TAIST).

Amphetamine increases blood pressure and heart rate but has no effect on motor recovery or cerebral haemodynamics in ischaemic stroke: a randomized controlled trial (ISRCTN 36285333) (2007)
Journal Article
Sprigg, N., Willmot, M., Gray, L. J., Sunderland, A., Pomeroy, V., Walker, M., & Bath, P. M. (2007). Amphetamine increases blood pressure and heart rate but has no effect on motor recovery or cerebral haemodynamics in ischaemic stroke: a randomized controlled trial (ISRCTN 36285333). Journal of Human Hypertension, 21(8),

Amphetamine enhances recovery after experimental ischaemia and has shown promise in small clinical trials when combined with motor or sensory stimulation. Amphetamine, a sympathomimetic, might have haemodynamic effects in stroke patients, although li... Read More about Amphetamine increases blood pressure and heart rate but has no effect on motor recovery or cerebral haemodynamics in ischaemic stroke: a randomized controlled trial (ISRCTN 36285333).

Effect of nitric oxide donors on blood pressure and pulse pressure in acute and subacute stroke (2006)
Journal Article
Gray, L. J., Sprigg, N., Rashid, P., Willmot, M., & Bath, P. M. (2006). Effect of nitric oxide donors on blood pressure and pulse pressure in acute and subacute stroke. Journal of Stroke and Cerebrovascular Diseases, 15(6),

High blood pressure (BP), pulse pressure (PP), and rate pressure product (RPP) areeach associated independently with a poor outcome in acute ischemic stroke. Whereas nitric oxide (NO) donors, such as glyceryl trinitrate (GTN), lower blood pressure i... Read More about Effect of nitric oxide donors on blood pressure and pulse pressure in acute and subacute stroke.

Significant variation in mortality and functional outcome after acute ischaemic stroke between western countries: data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST) (2006)
Journal Article
Gray, L. J., Sprigg, N., Bath, P. M., Sorensen, P., Lindenstrom, E., Boysen, G., …Turpie, A. (2006). Significant variation in mortality and functional outcome after acute ischaemic stroke between western countries: data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST). Journal of Neurology, Neurosurgery and Psychiatry, 77,

Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial (2005)
Journal Article
Sprigg, N., Gray, L. J., Bath, P. M., Boysen, G., de Deyn, P. P., Leys, D., …van der Sande, J. J. (2005). Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial. Journal of Stroke and Cerebrovascular Diseases, 14(5),

Background: Venous thromboembolism (VTE) is a well recognised and preventable complication of acute stroke. While graduated compression stockings reduce the risk of VTE in surgical patients their benefit in acute stroke remains uncertain. Methods: T... Read More about Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial.

A systematic review of nitric oxide donors and L-arginine in experimental stroke: effects on infarct size and cerebral blood flow (2005)
Journal Article
Willmot, M., Gray, L. J., Gibson, C. L., Murphy, S., & Bath, P. M. (2005). A systematic review of nitric oxide donors and L-arginine in experimental stroke: effects on infarct size and cerebral blood flow. Nitric Oxide: Biology and Chemistry, 12(3),

Background: Nitric oxide (NO) is a candidate treatment for acute ischaemic stroke, however published studies in experimental stroke have given conflicting results. Methods: We performed a systematic review of published controlled studies of L-arginin... Read More about A systematic review of nitric oxide donors and L-arginine in experimental stroke: effects on infarct size and cerebral blood flow.