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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
Joint Authors
Wardlaw, Joanna
Bath, Philip M. W.
Woodhouse, Lisa
Krishnan, Kailash
Anderson, Craig
Ford, Gary A.
Robinson, Thompson G.
Saver, Jeffrey L.
in Acute Stroke Collaboration (BASC), Blood pressure
Berge, Eivind
Sprigg, Nikola
Source
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-12, 12 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-04-17
Country of Publication
Egypt
No. of Pages
12
Main Subjects
Abstract EN
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 individual patient data (IPD) from completed trials.
Methods.
Randomised controlled trials of NO donors in patients with acute or subacute stroke were identified and IPD sought from the trialists.
The effect of NO donor versus control on functional outcome was assessed using the modified Rankin scale (mRS) and death, by time to randomisation.
Secondary outcomes included measures of disability, mood, and quality of life.
Results.
Five trials (4,197 participants) were identified, all involving glyceryl trinitrate (GTN).
Compared with control, GTN lowered blood pressure by 7.4/3.3 mmHg.
At day 90, GTN did not alter any clinical measures.
However, in 312 patients randomised within 6 hours of stroke onset, GTN was associated with beneficial shifts in the mRS (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.34–0.78) and reduced death (OR 0.32, 95% CI 0.14–0.78).
Conclusions.
NO donors do not alter outcome in patients with recent stroke.
However, when administered within 6 hours, NO donors might improve outcomes in both ischaemic and haemorrhagic stroke.
American Psychological Association (APA)
Bath, Philip M. W.& Woodhouse, Lisa& Krishnan, Kailash& Anderson, Craig& Berge, Eivind& Ford, Gary A.…[et al.]. 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،Vol. 2016, no. 2016, pp.1-12.
https://search.emarefa.net/detail/BIM-1118503
Modern Language Association (MLA)
Bath, Philip M. W.…[et al.]. 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 No. 2016 (2016), pp.1-12.
https://search.emarefa.net/detail/BIM-1118503
American Medical Association (AMA)
Bath, Philip M. W.& Woodhouse, Lisa& Krishnan, Kailash& Anderson, Craig& Berge, Eivind& Ford, Gary A.…[et al.]. 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. Vol. 2016, no. 2016, pp.1-12.
https://search.emarefa.net/detail/BIM-1118503
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1118503