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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.

Swallowing therapy for dysphagia in acute and subacute stroke (2018)
Journal Article
Bath, P. M., Lee, H. S., & Everton, L. F. (2018). Swallowing therapy for dysphagia in acute and subacute stroke. Cochrane Database of Systematic Reviews, https://doi.org/10.1002/14651858.CD000323.pub3

Background: Dysphagia (swallowing problems), which is common after stroke, is associated with increased risk of death or dependency, occurrence of pneumonia, poor quality of life, and longer hospital stay. Treatments provided to improve dysphagia are... Read More about Swallowing therapy for dysphagia in acute and subacute stroke.

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.

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.

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.

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.