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1. Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage: Data From the RIGHT-2 Trial.

Author

Bath, Philip, Woodhouse, Lisa, Krishnan, Kailash, Appleton, Jason, Anderson, Craig, Berge, Eivind, Cala, Lesley, Dixon, Mark, England, Timothy, Godolphin, Peter, Hepburn, Trish, Mair, Grant, Montgomery, Alan, Phillips, Stephen, Potter, John, Price, Chris, Randall, Marc, Robinson, Thompson, Roffe, Christine, Rothwell, Peter, Sandset, Else, Sanossian, Nerses, Siriwardena, A, Venables, Graham, Wardlaw, Joanna, Sprigg, Nikola, and Saver, Jeffrey

Subjects
allied health personnel, ambulances, blood pressure, humans, nitroglycerin, Acute Disease, Administration, Cutaneous, Aged, Aged, 80 and over, Blood Pressure, Cerebral Hemorrhage, Emergency Medical Services, Female, Hospital Mortality, Humans, Male, Middle Aged, Nitroglycerin, Prospective Studies, Stroke, Time Factors
Abstract

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 randomized, sham-controlled, blinded-end point trial in adults with presumed stroke within 4 hours of ictus. Participants received transdermal GTN (5 mg) or a sham dressing (1:1) in the ambulance and then daily for three days in hospital. The primary outcome was the 7-level modified Rankin Scale at 90 days assessed by central telephone treatment-blinded follow-up. This prespecified subgroup analysis focuses on participants with an intracerebral hemorrhage as their index event. Analyses are intention-to-treat. Results- Of 1149 participants with presumed stroke, 145 (13%; GTN, 74; sham, 71) had an intracerebral hemorrhage: time from onset to randomization median, 74 minutes (interquartile range, 45-110). By admission to hospital, blood pressure tended to be lower with GTN as compared with sham: mean, 4.4/3.5 mm Hg. The modified Rankin Scale score at 90 days was nonsignificantly higher in the GTN group: adjusted common odds ratio for poor outcome, 1.87 (95% CI, 0.98-3.57). A prespecified global analysis of 5 clinical outcomes (dependency, disability, cognition, quality of life, and mood) was worse with GTN; Mann-Whitney difference, 0.18 (95% CI, 0.01-0.35; Wei-Lachin test). GTN was associated with larger hematoma and growth, and more mass effect and midline shift on neuroimaging, and altered use of hospital resources. Death in hospital but not at day 90 was increased with GTN. There were no significant between-group differences in serious adverse events. Conclusions- Prehospital treatment with GTN worsened outcomes in patients with intracerebral hemorrhage. Since these results could relate to the play of chance, confounding, or a true effect of GTN, further randomized evidence on the use of vasodilators in ultra-acute intracerebral hemorrhage is needed. Clinical Trial Registration- URL: http://www.controlled-trials.com. Unique identifier: ISRCTN26986053.

Published
2019

2. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Author

Halliday, Alison, Bulbulia, Richard, Bonati, Leo H, Peto, Richard, Pan, Hongchao, Potter, John, Henning Eckstein, Hans, Farrell, Barbara, Flather, Marcus, Mansfield, Averil, Mihaylova, Boby, Rahimi, Kazim, Simpson, David, Thomas, Dafydd, Sandercock, Peter, Gray, Richard, Molyneux, Andrew, Shearman, Cliff P, Rothwell, Peter, Belli, Anna, Herrington, Will, Judge, Parminder, Leopold, Peter, Mafham, Marion, Gough, Michael, Cao, Piergiorgio, MacDonald, Sumaira, Bari, Vasha, Berry, Clive, Bradshaw, S, Brudlo, Wojciech, Clarke, Alison, Chester, Johanna, Cox, Robin, Cradduck-Bamford, Andrea, Fathers, Susan, Gaba, Kamran, Gray, Mo, Hayter, Elizabeth, Holliday, Constance, Kurien, Rijo, Lay, Michael, le Conte, Steffi, McManus, Jessica, Madgwick, Zahra, Morris, Dylan, Munday, Andrew, Pickworth, Sandra, Ostasz, Wiktor, Poorthuis, Michiel, Richards, Sue, Teixeira, Louisa, Tochlin, Sergey, Tully, Lynda, Wallis, Carol, Willet, Monique, Young, Alan, Casana, Renato, Malloggi, Chiara, Odero Jr, Andrea, Silani, Vincenzo, Parati, Gianfranco, Malchiodi, Giuseppe, Malferrari, Giovanni, Strozzi, Francesco, Tusini, Nicola, Vecchiati, Enrico, Coppi, Gioacchino, Lauricella, Antonio, Moratto, Roberto, Silingardi, Roberto, Veronesi, Jessica, Zini, Andrea, Ferrero, Emanuele, Ferri, Michelangelo, Gaggiano, Andrea, Labate, Carmelo, Nessi, Franco, Psacharopulo, Daniele, Viazzo, Andrea, Malacrida, Giovanni, Mazzaccaro, Daniela, Meola, Giovanni, Modafferi, Alfredo, Nano, Giovanni, Occhiuto, Maria Teresa, Righini, Paolo, Stegher, Silvia, Chiarandini, Stefano, Griselli, Filippo, Lepidi, Sandro, Pozzi Mucelli, Fabio, Naccarato, Marcello, D'Oria, Mario, Ziani, Barbara, Stella, Andrea, Dieng, Mortalla, Faggioli, Gianluca, Gargiulo, Mauro, Palermo, Sergio, Pini, Rodolfo, Puddu, Giovanni Maria, Vacirca, Andrea, Angiletta, Domenico, Desantis, Claudio, Marinazzo, Davide, Mastrangelo, Giovanni, Regina, Guido, Pulli, Raffaele, Bianchi, Paolo, Cireni, Lea, Coppi, Elisabetta, Pizzirusso, Rocco, Scalise, Filippo, Sorropago, Giovanni, Tolva, Valerio, Caso, Valeria, Cieri, Enrico, DeRango, Paola, Farchioni, Luca, Isernia, Giacomo, Lenti, Massimo, Parlani, Gian Battista, Pupo, Guglielmo, Pula, Grazia, Simonte, Gioele, Verzini, Fabio, Carimati, Federico, Delodovici, Maria Luisa, Fontana, Federico, Piffaretti, Gabriele, Tozzi, Matteo, Civilini, Efrem, Poletto, Giorgio, Reimers, Bernhard, Praquin, Barbara, Ronchey, Sonia, Capoccia, Laura, Mansour, Wassim, Sbarigia, Enrico, Speziale, Francesco, Sirignano, Pasqualino, Toni, Danilo, Galeotti, Roberto, Gasbarro, Vincenzo, Mascoli, Francesco, Rocca, Tiberio, Tsolaki, Elpiniki, Bernardini, Giulia, DeMarco, Ester, Giaquinta, Alessia, Patti, Francesco, Veroux, Massimiliano, Veroux, Pierfrancesco, Virgilio, Carla, Mangialardi, Nicola, Orrico, Matteo, Di Lazzaro, Vincenzo, Montelione, Nunzio, Spinelli, Francesco, Stilo, Francesco, Cernetti, Carlo, Irsara, Sandro, Maccarrone, Giuseppe, Tonello, Diego, Visonà, Adriana, Zalunardo, Beniamino, Chisci, Emiliano, Michelagnoli, Stefano, Troisi, Nicola, Masato, Maela, Dei Negri, Massimo, Pacchioni, Andrea, Saccà, Salvatore, Amatucci, Giovanni, Cannizzaro, Alfredo, Accrocca, Federico, Ambrogi, Cesare, Barbazza, Renzo, Marcucci, Giustino, Siani, Andrea, Bajardi, Guido, Savettieri, Giovanni, Argentieri, Angelo, Corbetta, Riccardo, Odero, Attilio, Quaretti, Pietro, Thyrion, Federico Z, Cappelli, Alessandro, Benevento, Domenico, De Donato, Gianmarco, Mele, Maria Agnese, Palasciano, Giancarlo, Pieragalli, Daniela, Rossi, Alessandro, Setacci, Carlo, Setacci, Francesco, Palombo, Domenico, Perfumo, Maria Cecilia, Martelli, Edoardo, Paolucci, Aldo, Trimarchi, Santi, Grassi, Viviana, Grimaldi, Luigi, La Rosa, Giuliana, Mirabella, Domenico, Scialabba, Matteo, Sichel, Leonildo, D'Angelo, Costantino L, Fadda, Gian Franco, Kasemi, Holta, Marino, Mario, Burzotta, Francesco, Codispoti, Francesco Alberto, Ferrante, Angela, Tinelli, Giovanni, Tshomba, Yamume, Vincenzoni, Claudio, Amis, Deborah, Anderson, Dawn, Catterson, Martin, Clarke, Mike, Davis, Michelle, Dixit, Anand, Dyker, Alexander, Ford, Gary, Jackson, Ralph, Kappadath, Sreevalsan, Lambert, David, Lees, Tim, Louw, Stephen, McCaslin, James, Parr, Noala, Robson, Rebecca, Stansby, Gerard, Wales, Lucy, Wealleans, Vera, Wilson, Lesley, Wyatt, Michael, Baht, Hardeep, Balogun, Ibrahim, Burger, Ilse, Cosier, Tracy, Cowie, Linda, Gunathilagan, Gunaratnam, Hargroves, David, Insall, Robert, Jones, Sally, Rudenko, Hannah, Schumacher, Natasha, Senaratne, Jawaharlal, Thomas, George, Thomson, Audrey, Webb, Tom, Brown, Ellen, Esisi, Bernard, Mehrzad, Ali, MacSweeney, Shane, McConachie, Norman, Southam, Alison, Sunman, Wayne, Abdul-Hamiq, Ahmed, Bryce, Jenny, Chetter, Ian, Ettles, Duncan, Lakshminarayan, Raghuram, Mitchelson, Kim, Rhymes, Christopher, Robinson, Graham, Scott, Paul, Vickers, Alison, Ashleigh, Ray, Butterfield, Stephen, Gamble, Ed, Ghosh, Jonathan, McCollum, Charles N, Welch, Mark, Welsh, Sarah, Wolowczyk, Leszek, Donnelly, Mary, D'Souza, Stephen, Egun, Anselm A, Gregary, Bindu, Joseph, Thomas, Kelly, Christine, Punekar, Shuja, Rahi, M Asad, Raj, Sonia, Seriki, Dare, Thomson, George, Brown, James, Durairajan, Ragunath, Grunwald, Iris, Guyler, Paul, Harman, Paula, Jakeways, Matthew, Khuoge, Christopher, Kundu, Ashish, Loganathan, Thayalini, Menon, Nisha, Prabakaran, Raji O, Sinha, Devesh, Thompson, Vicky, Tysoe, Sharon, Briley, Dennis, Darby, Chris, Hands, Linda, Howard, Dominic, Kuker, Wilhelm, Schulz, Ursula, Teal, Rachel, Barer, David, Brown, Andrew, Crawford, Susan, Dunlop, Paul, Krishnamurthy, Ramesh, Majmudar, Nikhil, Mitchell, Duncan, Myint, Min P, O'Brien, Richard, O'Connell, Janice, Sattar, Naweed, Vetrivel, Shanmugam, Beard, Jonathan, Cleveland, Trevor, Gaines, Peter, Humphreys, John, Jenkins, Alison, King, Craig, Kusuma, Daniel, Lindert, Ralph, Lonsdale, Robbie, Nair, Raj, Nawaz, Shah, Okhuoya, Faith, Turner, Douglas, Venables, Graham, Dorman, Paul, Hughes, Andrea, Jones, Deborah, Mendelow, David, Rodgers, Helen, Raudoniitis, Aidas, Enevoldson, Peter, Nahser, Hans, O'Brien, Imelda, Torella, Francesco, Watling, Dave, White, Richard, Brown, Pauline, Dutta, Dipankar, Emerson, Lorraine, Hilltout, Paula, Kulkarni, Sachin, Morrison, Jackie, Poskitt, Keith, Slim, Fiona, Smith, Sarah, Tyler, Amanda, Waldron, Joanne, Whyman, Mark, Bajoriene, Milda, Baker, Lucy, Colston, Amanda, Eliot-Jones, Bekky, Gramizadeh, Gita, Lewis-Clarke, Catherine, McCafferty, Laura, Oliver, Deborah, Palmer, Debbie, Patil, Abhijeet, Pegler, Suzannah, Ramadurai, Gopi, Roberts, Aisling, Sargent, Tracey, Siddegowda, Shivaprasad, Singh-Ranger, Ravi, Williams, Akintunde, Williams, Lucy, Windebank, Steve, Zuromskis, Tadas, Alwis, Lanka, Angus, Jane, Asokanathan, Asaipillai, Fornolles, Caroline, Hardy, Diana, Hunte, Sophy, Justin, Frances, Phiri, Duke, Mitabouana-Kibou, Marie, Sekaran, Lakshmanan, Sethuraman, Sakthivel, Tate, Margaret L, Akyea-Mensah, Joyce, Ball, Stephen, Chrisopoulou, Angela, Keene, Elizabeth, Phair, Alison, Rogers, Steven, Smyth, John V, Bicknell, Colin, Chataway, Jeremy, Cheshire, Nicholas, Clifton, Andrew, Eley, Caroline, Gibbs, Richard, Hamady, Mohammad, Hazel, Beth, James, Alex, Jenkins, Michael, Khanom, Nyma, Lacey, Austin, Mireskandari, Maz, O'Reilly, Joanna, Pereira, Antony, Sachs, Tina, Wolfe, John, Davey, Philip, Rogers, Gill, Smith, Gemma, Tervit, Gareth, Nichol, Ian, Parry, Andrew, Young, Gavin, Ashley, Simon, Barwell, James, Dix, Francis, Nor, Azlisham M, Parry, Chris, Birt, Angela, Davies, Paul, George, Jim, Graham, Anne, Jonker, Leon, Kelsall, Nicci, Potts, Caroline, Wilson, Toni, Crinnion, Jamie, Cuenoud, Larissa, Aleksic, Nikola, Babic, Srdan, Ilijevski, Nenad, Radak, Đorde, Sagic, Dragan, Tanaskovic, Slobodan, Colic, Momcilo, Cvetic, Vladimir, Davidovic, Lazar, Jovanovic, Dejana R, Koncar, Igor, Mutavdžic, Perica, Sladojevic, Miloš, Tomic, Ivan, Debus, Eike S, Grzyska, Ulrich, Otto, Dagmar, Thomalla, Götz, Barlinn, Jessica, Gerber, Johannes, Haase, Kathrin, Hartmann, Christian, Ludwig, Stefan, Pütz, Volker, Reeps, Christian, Schmidt, Christine, Weiss, Norbert, Werth, Sebastian, Winzer, Simon, Gemper, Janine, Günther, Albrecht, Heiling, Bianka, Jochmann, Elisabeth, Karvouniari, Panagiota, Klingner, Carsten, Mayer, Thomas, Schubert, Julia, Schulze-Hartung, Friederike, Zanow, Jürgen, Bausback, Yvonne, Borger, Franka, Botsios, Spiridon, Branzan, Daniela, Bräunlich, Sven, Hölzer, Henryk, Lenzer, Janin, Piorkowski, Christopher, Richter, Nadine, Schuster, Johannes, Scheinert, Dierk, Schmidt, Andrej, Staab, Holger, Ulrich, Matthias, Werner, Martin, Berger, Hermann, Biró, Gábor, Eckstein, Hans-Henning, Kallmayer, Michael, Kreiser, Kornelia, Zimmermann, Alexander, Berekoven, Bärbel, Frerker, Klaus, Gordon, Vera, Torsello, Giovanni, Arnold, Sebastian, Dienel, Cora, Storck, Martin, Biermaier, Bernhard, Gissler, Hans Martin, Klötzsch, Christof, Pfeiffer, Tomas, Schneider, Ralph, Söhl, Leander, Wennrich, Michael, Alonso, Angelika, Keese, Michael, Groden, Christoph, Cöster, Andreas, Engelhardt, Andreas, Ratusinski, Christoph-Maria, Berg, Bengt, Delle, Martin, Formgren, Johan, Gillgren, Peter, Jarl, Lotta, Kall, Torbjörn B, Konrad, Peter, Nyman, Niklas, Skiöldebrand, Claes, Steuer, Johnny, Takolander, Rabbe, Malmstedt, Jonas, Acosta, Stefan, Björses, Katarina, Brandt, Kerstin, Dias, Nuno, Gottsäter, Anders, Holst, Jan, Kristmundsson, Thorarinn, Kühme, Tobias, Kölbel, Tilo, Lindblad, Bengt, Lindh, Mats, Malina, Martin, Ohrlander, Tomas, Resch, Tim, Rönnle, Viola, Sonesson, Björn, Warvsten, Margareta, Zdanowski, Zbigniew, Campbell, Erik, Kjellin, Per, Lindgren, Hans, Nyberg, Johan, Petersen, Björn, Plate, Gunnar, Pärsson, Håkan, Qvarfordt, Peter, Ignatenko, Pavel, Karpenko, Andrey, Starodubtsev, Vladimir, Chernyavsky, Mikhail A, Golovkova, Maria S, Komakha, Boris B, Zherdev, Nikolay N, Belyasnik, Andrey, Chechulov, Pavel, Kandyba, Dmitry, Stepanishchev, Igor, Csobay-Novák, Csaba, Dósa, Edit, Entz, László, Nemes, Balázs, Szeberin, Zoltán, Barzó, Pál, Bodosi, Mihaly, Fákó, Eniko, Fülöp, Béla, Németh, Tamás, Pazdernyik, Szilárd, Skoba, Krisztina, Vörös, Erika, Chatzinikou, Eleni, Giannoukas, Athanasios, Karathanos, Christos, Koutsias, Stylianos, Kouvelos, Georgios, Matsagkas, Miltiadis, Ralli, Styliani, Rountas, Christos, Rousas, Nikolaos, Spanos, Konstantinos, Brountzos, Elias, Kakisis, John D, Lazaris, Andreas, Moulakakis, Konstantinos G, Stefanis, Leonidas, Tsivgoulis, Georgios, Vasdekis, Spyros, Antonopoulos, Constantine N, Bellenis, Ion, Maras, Dimitrios, Polydorou, Antonios, Polydorou, Victoria, Tavernarakis, Antonios, Ioannou, Nikolaos, Terzoudi, Maria, Lazarides, Miltos, Mantatzis, Michalis, Vadikolias, Kostas, Dzieciuchowicz, Lukasz, Gabriel, Marcin, Krasinski, Zbigniew, Oszkinis, Grzegorz, Pukacki, Fryderyk, Slowinski, Maciej, Stanišic, Michal-Goran, Staniszewski, Ryszard, Tomczak, Jolanta, Zielinski, Maciej, Myrcha, Piotr, Rózanski, Dorota, Drelichowski, Stanislaw, Iwanowski, Wojciech, Koncewicz, Katarzyna, Bialek, Pawel, Biejat, Zbigniew, Czepel, Wojciech, Czlonkowska, Anna, Dowzenko, Anatol, Jedrzejewska, Julia, Kobayashi, Adam, Leszczynski, Jerzy, Malek, Andrzej, Polanski, Jerzy, Proczka, Robert, Skorski, Maciej, Szostek, Mieczyslaw, Andziak, Piotr, Dratwicki, Maciej, Gil, Robert, Nowicki, Miroslaw, Pniewski, Jaroslaw, Rzezak, Jaroslaw, Seweryniak, Piotr, Dabek, Pawel, Juszynski, Michal, Madycki, Grzegorz, Pacewski, Bartosz, Raciborski, Witold, Slowinski, Piotr, Staszkiewicz, Walerian, Bombic, Martin, Chlouba, Vladimír, Fiedler, Jirí, Hes, Karel, Koštál, Petr, Sova, Jindrich, Kríž, Zdenek, Prívara, Mojmír, Reif, Michal, Staffa, Robert, Vlachovský, Robert, Vojtíšek, Bohuslav, Hrbác, Tomáš, Kuliha, Martin, Procházka, Václav, Roubec, Martin, Školoudík, David, Netuka, David, Šteklácová, Anna, Beneš III, Vladimír, Buchvald, Pavel, Endrych, Ladislav, Šercl, Miroslav, Campos Jr, Walter, Casella, Ivan B, de Luccia, Nelson, Estenssoro, André E V, Presti, Calógero, Puech-Leão, Pedro, Neves, Celso R B, da Silva, Erasmo S, Sitrângulo Jr, Cid J, Monteiro, José A T, Tinone, Gisela, Bellini Dalio, Marcelo, Joviliano, Edwaldo E, Pontes Neto, Octávio M, Serra Ribeiro, Mauricio, Cras, Patrick, Hendriks, Jeroen M H, Hoppenbrouwers, Mieke, Lauwers, Patrick, Loos, Caroline, Yperzeele, Laetitia, Geenens, Mia, Hemelsoet, Dimitri, van Herzeele, Isabelle, Vermassen, Frank, Astarci, Parla, Hammer, Frank, Lacroix, Valérie, Peeters, André, Verhelst, Robert, Cirelli, Silvana, Dormal, Pol, Grimonprez, Annelies, Lambrecht, Bart, Lerut, Philipe, Thues, Eddy, De Koster, Guy, Desiron, Quentin, Maertens de Noordhout, Alain, Malmendier, Danielle, Massoz, Mireille, Saad, Georges, Bosiers, Marc, Callaert, Joren, Deloose, Koen, Blanco Cañibano, Estrella, García Fresnillo, Beatriz, Guerra Requena, Mercedes, Morata Barrado, Pilar C, Muela Méndez, Miguel, Yusta Izquierdo, Antonio, Aparici Robles, Fernando, Blanes Orti, Paula, García Dominguez, Luis, Martínez López, Rafael, Miralles Hernández, Manuel, Tembl Ferrairo, José I, Chamorro, Ángel, Macho, Juan, Obach, Víctor, Riambau, Vincent, San Román, Luis, Ahlhelm, Frank J, Blackham, Kristine, Engelter, Stefan, Eugster, Thomas, Gensicke, Henrik, Gürke, Lorenz, Lyrer, Philippe, Mariani, Luigi, Maurer, Marina, Mujagic, Edin, Müller, Mandy, Psychogios, Marios, Stierli, Peter, Stippich, Christoph, Traenka, Christopher, Wolff, Thomas, Wagner, Benjamin, Wiegert, Martina M, Clarke, Sandra, Diepers, Michael, Gröchenig, Ernst, Gruber, Philipp, Isaak, Andrej, Kahles, Timo, Marti, Regula, Nedeltchev, Krassen, Remonda, Luca, Tissira, Nadir, Valença Falcão, Martina, de Borst, Gert J, Lo, Rob H, Moll, Frans L, Toorop, Raechel, van der Worp, Bart H, Vonken, Evert J, Kappelle, Jaap L, Jahrome, Ommid, Vos, Floris, Schuiling, Wouter, van Overhagen, Hendrik, Keunen, Rudolf W M, Knippenberg, Bob, Wever, Jan J, Lardenoije, Jan W, Reijnen, Michel, Smeets, Luuk, van Sterkenburg, Steven, Fraedrich, Gustav, Gizewski, Elke, Gruber, Ingrid, Knoflach, Michael, Kiechl, Stefan, Rantner, Barbara, Abdulamit, Timur, Bergeron, Patrice, Padovani, Raymond, Trastour, Jean-Christophe, Cardon, Jean-Marie, Le Gallou-Wittenberg, Anne, Allaire, Eric, Becquemin, Jean-Pierre, Cochennec-Paliwoda, Frédéric, Desgranges, Pascal, Hosseini, Hassan, Kobeiter, Hicham, Marzelle, Jean, Almekhlafi, Mohammed A, Bal, Simerpreet, Barber, Phillip A, Coutts, Shelagh B, Demchuk, Andrew M, Eesa, Muneer, Gillies, Michelle, Goyal, Mayank, Hill, Michael D, Hudon, Mark E, Jambula, Anitha, Kenney, Carol, Klein, Gary, McClelland, Marie, Mitha, Alim, Menon, Bijoy K, Morrish, William F, Peters, Steven, Ryckborst, Karla J, Samis, Greg, Save, Supriya, Smith, Eric E, Stys, Peter, Subramaniam, Suresh, Sutherland, Garnette R, Watson, Tim, Wong, John H, Zimmel, L, Flis, Vojko, Matela, Jože, Miksic, Kazimir, Milotic, Franko, Mrdja, Božidar, Stirn, Barbara, Tetickovic, Erih, Gasparini, Mladen, Grad, Anton, Kompara, Ingrid, Miloševic, Zoren, Palmiste, Veronika, Toomsoo, Toomas, Aidashova, Balzhan, Kospanov, Nursultan, Lyssenko, Roman, Mussagaliev, Daulet, Beyar, Rafi, Hoffman, Aaron, Karram, Tony, Kerner, Arthur, Nikolsky, Eugenia, Nitecki, Samy, Andonova, Silva, Bachvarov, Chavdar, Petrov, Vesko, Cvjetko, Ivan, Vidjak, Vinko, Halužan, Damir, Petrunic, Mladen, Liu, Bao, Liu, Chang-Wei, Bartko, Daniel, Beno, Peter, Rusnák, František, Zelenák, Kamil, Ezura, Masayuki, Inoue, Takashi, Kimura, Naoto, Kondo, Ryushi, Matsumoto, Yasushi, Shimizu, Hiroaki, Endo, Hidenori, Furui, Eisuke, Bakke, Søren, Krohg-Sørensen, Kristen, Nome, Terje, Skjelland, Mona, Tennøe, Bjørn, Albuquerque e Castro, João, Alves, Gonçalo, Bastos Gonçalves, Frederico, de Aragão Morais, José, Garcia, Ana C, Valentim, Hugo, Vasconcelos, Leonor, Belcastro, Fernando, Cura, Fernando, Zaefferer, Patricio, Abd-Allah, Foad, Eldessoki, Mohamed H, Heshmat Kassem, Hussein, Soliman Gharieb, Haytham, Colgan, Mary P, Haider, Syed N, Harbison, Joe, Madhavan, Prakash, Moore, Dermot, Shanik, Gregor, Kazan, Viviane, Nazzal, Munier, and Ramsey-Williams, Vicki

Published
2021
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3. Restenosis and risk of stroke after stenting or endarterectomy for symptomatic carotid stenosis in the International Carotid Stenting Study (ICSS): secondary analysis of a randomised trial

Author

Algra, Ale, Bakke, S J, Baldwin, Neil, Beard, Jonathan, Bladin, Christopher, Bland, J Martin, Boiten, J, Bosiers, Mark, Bradbury, A W, Canovas, David, Chambers, Brian, Chamorro, Angel, Chataway, Jonathan, Clifton, Andrew, Collins, Rory, Coward, Lucy, Czlonkowska, Anna, Davis, Stephen, DeJaegher, L, Doig, David, Dorman, Paul, Ederle, Jörg, Featherstone, Roland F, Ferro, Jose M, Gaines, Peter, Gilling-Smith, G, Goertler, M, Gottsäter, A, Hacke, Werne, Halliday, Alison, Hamilton, George, Hendriks, J M H, Hill, Michael, Kapelle, L Jaap, Kaste, Markku, Kennedy, Fiona, Konrad, P, Kool, LJS, Koudstaal, Peter J, Malik, I, Markus, Hugh, Martin, Peter, Mas, Jean-Louis, McCollum, Charles, McGahan, T, McGuire, A J, Michel, Philippe, Molyneux, Andrew, Moroney, Jane, Mosch, A, Moss, J, Naylor, Ross, Peeters, A, Roy, D, Schultz, David, Seriki, D M, Shinton, R A, Sidhu, Paul, Stewart, J, Subramanian, G, Sztajzel, R, Than, P G, Thomas, Daffyd, Turner, E, van den Berg, J S P, Vanhooren, G, Venables, Graham, Wahlgren, Nils, Walker, S, Warlow, Charles, Zvan, Bojana, Bonati, Leo H, Gregson, John, Dobson, Joanna, McCabe, Dominick J H, Nederkoorn, Paul J, van der Worp, H Bart, de Borst, Gert J, Richards, Toby, Cleveland, Trevor, Müller, Mandy D, Wolff, Thomas, Engelter, Stefan T, Lyrer, Philippe A, and Brown, Martin M

Published
2018
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6. Translating research into practice: Lessons from trials of thrombolysis in acute stroke

Author

Venables Graham

Subjects
Ischemic stroke, thrombolytic therapy, Neurology. Diseases of the nervous system, RC346-429
Abstract

There exist individual, institutional and national barriers to change, none more so than when introducing new therapies into medical practice especially those that involve organizational change. This paper, presented as an address to the joint meeting of the Association of British Neurologists and the Indian Academy of Neurology in October 2007, explores these barriers in the context of the instruction of thrombolytic therapy for patients with acute ischaemic stroke and suggests how they might be overcome using evidence from relevant clinical trials and observational studies.

Published
2008

7. Alteplase for Acute Ischemic Stroke: Outcomes by Clinically Important Subgroups in the Third International Stroke Trial

Author

Lindley, Richard I., Wardlaw, Joanna M., Whiteley, William N., Cohen, Geoff, Blackwell, Lisa, Murray, Gordon D., Sandercock, Peter A.G., Baigent, Colin, Professor, Chadwick, David, Professor, Tyrrell, Pippa, Dr, Lowe, Gordon, Professor, Dennis, Martin, Professor, Innes, Karen, Ms, Goodare, Heather, Farrall, Andrew, von Kummer, Rüdiger, Cala, Lesley, von Heijne, Anders, Morris, Zoe, Adami, Alessandro, Peeters, Andre, Potter, Gillian, Brady, Nick, Collins, Rory, Professor, Bath, Philip, Professor, van Gijn, Jan, Professor, Gray, Richard, Professor, Hart, Robert, Professor, Yusuf, Salim, Professor, Muir, Keith, Hankey, Graeme J., Matz, Karl, Brainin, Michael, Peters, Andre, Gubitz, Gord, Phillips, Stephen, Ricci, Stefano, Arauz, Antonio, Berge, Eivind, Bruins Slot, Karsten, Czlonkowska, Anna, Kobayashi, Adam, Correia, Manuel, Lyrer, Phillippe, Engelter, Stefan, Murray, Veronica, Norrving, Bo, Terént, Andreas, Wester, Per, Venables, Graham, Innes, Karen, Clark, Alison, Perry, David, Soosay, Vera, Buchanan, David, Grant, Sheila, Sakka, Eleni, Drever, Jonathan, Walker, Pauli, Herath, Indee, Brown, Ann Leigh, Chmielnik, Paul, Armit, Christopher, Walton, Andrea, Hautvast, Mischa, Lewis, Steff, Heron, Graeme, Odusanya, Sylvia, Linksted, Pam, Kane, Ingrid, Sellar, Robin, White, Philip, Keston, Peter, Farrell, Andrew, Morris, Zoe, Miranda, Hector, Celani, Maria Grazia, Righetti, Enrico, Cenciarelli, Silvia, Mazzoli, Tatiana, Cantisani, Teresa Anna, Bembenek, Jan, and Isaakson, Eva

Published
2015
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9. Long-term risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial

Author

Bonati, Leo H, Ederle, Jörg, McCabe, Dominick JH, Dobson, Joanna, Featherstone, Roland L, Gaines, Peter A, Beard, Jonathan D, Venables, Graham S, Markus, Hugh S, Clifton, Andrew, Sandercock, Peter, and Brown, Martin M

Published
2009
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12. Effect of the neutral CLOTS 1 trial on the use of graduated compression stockings in the Efficacy of Nitric Oxide Stroke (ENOS) trial

Author

Ankolekar, Sandeep, Renton, Cheryl, Bereczki, Daniel, Sprigg, Nikola, Payne, Tanya, Gommans, John, Berge, Eivind, Wardlaw, Joanna, Dennis, Martin S, Bath, Philip M W, Amarenco, Pierre, Bath, Philip, Lees, Kennedy R, Muir, Keith, Pocock, Stuart, Shone, Angela, Sinclair, Jane, Venables, Graham, Wardlaw, Joanna, Whynes, David, Bladin, Chris, Caso, Valeria, Chang, Hui Meng, Collins, Ronan, Czlonkowska, Anna, El Etribi, Anwar, Ghani, Abdul Raman, Gommans, John, Phillips, Stephen, Prasad, Kameshwar, de Silva, Asita, Szatmari, Szabolcs, de Tejedor, Exuperio, Wang, Yong-Jun, and Wong, Lawrence

Published
2013
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15. Multifocal motor neuropathy

Author

Biessels, G. J., Franssen, Hessel, van den Berg, Leonard H., Gibson, Andrew, Kappelle, L. Jaap, Venables, Graham S., and Wokke, John H. J.

Published
1997
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16. Prehospital transdermal glyceryl trinitrate for ultra-acute intracerebral hemorrhage

Author

Bath, Philip M., Woodhouse, Lisa J., Krishnan, Kailash, Appleton, Jason P., Anderson, Craig S., Berge, Eivind, Cala, Lesley, Dixon, Mark, England, Timothy J., Godolphin, Peter J., Hepburn, Trish, Mair, Grant, Montgomery, Alan A., Phillips, Stephen J., Potter, John, Price, Chris I., Randall, Marc, Robinson, Thompson G., Roffe, Christine, Rothwell, Peter M., Sandset, Else C., Sanossian, Nerses, Saver, Jeffrey L., Siriwardena, A. Niroshan, Venables, Graham, Wardlaw, Joanna M., and Sprigg, Nikola

Subjects
Male, Emergency Medical Services, Time Factors, A300 Clinical Medicine, Original Contributions, Clinical Sciences, Blood Pressure, Administration, Cutaneous, Nitroglycerin, ambulances, Humans, Hospital Mortality, Prospective Studies, Aged, Cerebral Hemorrhage, Aged, 80 and over, allied health personnel, Middle Aged, RC666, Stroke, Acute Disease, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, cardiovascular system, Female, B990 Subjects Allied to Medicine not elsewhere classified, circulatory and respiratory physiology
Abstract

Supplemental Digital Content is available in the text., 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 randomized, sham-controlled, blinded-end point trial in adults with presumed stroke within 4 hours of ictus. Participants received transdermal GTN (5 mg) or a sham dressing (1:1) in the ambulance and then daily for three days in hospital. The primary outcome was the 7-level modified Rankin Scale at 90 days assessed by central telephone treatment-blinded follow-up. This prespecified subgroup analysis focuses on participants with an intracerebral hemorrhage as their index event. Analyses are intention-to-treat. Results— Of 1149 participants with presumed stroke, 145 (13%; GTN, 74; sham, 71) had an intracerebral hemorrhage: time from onset to randomization median, 74 minutes (interquartile range, 45–110). By admission to hospital, blood pressure tended to be lower with GTN as compared with sham: mean, 4.4/3.5 mm Hg. The modified Rankin Scale score at 90 days was nonsignificantly higher in the GTN group: adjusted common odds ratio for poor outcome, 1.87 (95% CI, 0.98–3.57). A prespecified global analysis of 5 clinical outcomes (dependency, disability, cognition, quality of life, and mood) was worse with GTN; Mann-Whitney difference, 0.18 (95% CI, 0.01–0.35; Wei-Lachin test). GTN was associated with larger hematoma and growth, and more mass effect and midline shift on neuroimaging, and altered use of hospital resources. Death in hospital but not at day 90 was increased with GTN. There were no significant between-group differences in serious adverse events. Conclusions— Prehospital treatment with GTN worsened outcomes in patients with intracerebral hemorrhage. Since these results could relate to the play of chance, confounding, or a true effect of GTN, further randomized evidence on the use of vasodilators in ultra-acute intracerebral hemorrhage is needed. Clinical Trial Registration— URL: http://www.controlled-trials.com. Unique identifier: ISRCTN26986053.

Published
2019

29. Bringing neurology to the people

Author

Warlow, Charles, Allen, Chris, and Venables, Graham

Subjects
Neurology -- Practice, Neurologists -- Training, Neurologists -- Services, Health, Psychology and mental health
Published
2008

30. A randomized double-blind controlled trial of naftidrofuryl in acute stroke

Author

Gray, Christopher S., French, Joyce M., Venables, Graham S., Cartlidge, Niall E.F., James, Oliver F., and Bates, David

Subjects
Stroke (Disease) -- Drug therapy, Stroke patients -- Care and treatment, Pharmaceutical research -- Analysis, Health, Psychology and mental health, Seniors, Social sciences
Abstract

There is evidence to support the use of naftidrofuryl in acute stroke with claims of increased recovery, reduced fatality and reduced bed occupancy in patients treated with either oral or intravenous preparations. One hundred patients presenting with acute hemisphere stroke < 72 hours) were randomized to receive either a new oral formulation of naftidrofuryl or placebo on a double-blind basis. Treatment was given for a total of 12 weeks and patients followed for 26 weeks with serial neurological and functional assessments by a single observer. Cumulative fatality and hospital-bed occupancy were determined at each assessment interval. No significant difference was demonstrated in cumulative fatality, hospital-bed occupancy or recovery of motor function in patients treated with either naftidrofuryl or placebo. There is no evidence from this study to support the use of oral naftidrofuryl in acute stroke.

Published
1990

31. Motor recovery following acute stroke

Author

Gray, Christopher S., French, Joyce M., Bates, David, Cartlidge, Niall E.F., James, Oliver F.W., and Venables, Graham

Subjects
Stroke patients -- Physiological aspects, Stroke (Disease) -- Physiological aspects, Muscle tone -- Research, Muscle strength -- Research, Health, Psychology and mental health, Seniors, Social sciences
Abstract

Summary There is little information available from which normal patterns of recovery from acute stroke can be ascertained. Most attention has been directed towards functional recovery in stroke patients but the neurological basis on which this occurs needs to be documented in a large cohort of patients. One hundred and fifty-seven patients admitted to hospital with a clinical diagnosis of acute stroke were examined daily for up to 28 days to determine the patterns of recovery of limb tone, power and reflexes. Changes in these variables during the first 28 days after stroke are described.

Published
1990

32. Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial

Author

Bath, Philip M, primary, Scutt, Polly, additional, Anderson, Craig S, additional, Appleton, Jason P, additional, Berge, Evind, additional, Cala, Lesley, additional, Dixon, Mark, additional, England, Timothy M, additional, Godolphin, Peter J, additional, Havard, Diane, additional, Haywood, Lee, additional, Hepburn, Trish, additional, Krishnan, Kailash, additional, Mair, Grant, additional, Montgomery, Alan A, additional, Muir, Keith, additional, Phillips, Stephen J, additional, Pocock, Stuart, additional, Potter, John, additional, Price, Chris, additional, Randall, Marc, additional, Robinson, Thompson G, additional, Roffe, Christine, additional, Rothwell, Peter M, additional, Sandset, Else C, additional, Sanossian, Nerses, additional, Saver, Jeffrey L, additional, Shone, Angela, additional, Siriwardena, A Niroshan, additional, Wardlaw, Joanna M, additional, Woodhouse, Lisa J, additional, Venables, Graham, additional, Sprigg, Nikola, additional, Amarenco, Pierre, additional, Amoils, Shannon, additional, Jarvis, Malcolm, additional, Sandercock, Peter, additional, Asplund, Kjell, additional, Baigent, Colin, additional, Ankolekar, Sandeep, additional, Howard, Harriet, additional, Lysons, Christopher, additional, Walker, Gemma, additional, Gregory, Hayley, additional, Kirby, James, additional, Smithson, Jennifer, additional, Keeling, Joanne, additional, Frowd, Nadia, additional, Gray, Robert, additional, Dooley, Richard, additional, Clarke, Wim, additional, Robinson, Patricia, additional, Law, Zhe Kang, additional, Hodgson, Sheila, additional, Millington, Adam, additional, Sakka, Eleni, additional, Buchanan, David, additional, Palmer, Jeb, additional, Shaw, D, additional, Cobb, H, additional, Johnson, R, additional, Payne, T, additional, Spaight, R, additional, Spaight, A, additional, Sajid, M A, additional, Whileman, A, additional, Hall, E, additional, Cripps, H, additional, Toms, J, additional, Gascoyne, R, additional, Wright, S, additional, Cooper, M, additional, Palfreman, A, additional, Rajapakse, A, additional, Wynter, I, additional, Musarrat, K, additional, Mistri, A, additional, Patel, C, additional, Stephens, C, additional, Khan, S, additional, Patras, S, additional, Soliman, M, additional, Elmarimi, A, additional, Hewitt, C, additional, Watson, E, additional, Wahishi, I, additional, Hindle, J, additional, Perkin, L, additional, Wills, M, additional, Arif, S, additional, Leach, S, additional, Butler, S, additional, O'Kane, D, additional, Smith, C, additional, O'Callaghan, J, additional, Sunman, W, additional, Buck, A, additional, Jackson, B, additional, Richardson, C, additional, Wilkes, G, additional, Clarke, J, additional, Ryan, L, additional, Matias, O, additional, Mangion, D, additional, Hardwick, A, additional, Constantin, C, additional, Thomas, I, additional, Netherton, K, additional, Markova, S, additional, Hedstrom, A, additional, Rushton, B, additional, Hyde, C, additional, Scott, J, additional, Blair, M, additional, Maddula, M, additional, Donnelly, R, additional, Keane, S, additional, Johnson, S, additional, McKenzie, H, additional, Banerjee, A, additional, Hutchinson, D, additional, Goodhand, H, additional, Hill, J, additional, Mellows, K, additional, Cheeseman, M, additional, McTaggart, V, additional, Foster, T, additional, Prothero, L, additional, Saksena, P, additional, O'Kelly, A, additional, Wyllie, H, additional, Hacon, C, additional, Nutt, H, additional, North, J, additional, Goffin, K, additional, Potter, J, additional, Wiltshire, A, additional, Ravenhill, G, additional, Metcalf, K, additional, Ford, L, additional, Langley, M, additional, Davison, W, additional, Subramonian, S, additional, Magezi, F, additional, Obi, I, additional, Temple, N, additional, Butterworth-Cowin, N, additional, Oqwusu-Agyei, P, additional, Azim, A F M, additional, Nicolson, A, additional, Imam, J, additional, White, J, additional, Wood, L, additional, Fothergill, R, additional, Thompson, N, additional, Lazarus, J, additional, Werts, H, additional, Sztriha, L, additional, Ho, C, additional, McKenzie, E, additional, Owoyele, E, additional, Lim, J, additional, Aeron-Thomas, J, additional, Dockey, M, additional, Sylvester, N, additional, Rao, P, additional, Bloom, B M, additional, Erumere, E, additional, Norman, G, additional, Skene, I, additional, Cuenoud, L, additional, Howaniec, L, additional, Boulton, O, additional, Daboo, P, additional, Michael, R, additional, Al-Saadi, S, additional, Harrison, T, additional, Syed, H, additional, Argandona, L, additional, Amiani, S, additional, Perry, R, additional, Ashton, A, additional, Banaras, A, additional, Hogan, C, additional, Watchurst, C, additional, Elliott, E, additional, Francia, N, additional, Oji, N, additional, Erande, R, additional, Obarey, S, additional, Feerick, S, additional, Tshuma, S, additional, England, E, additional, Pocock, H, additional, Poole, K, additional, Manchanda, S, additional, Burn, I, additional, Dayal, S, additional, McNee, K, additional, Robinson, M, additional, Hancock, R, additional, South, A, additional, Holmes, C, additional, Steele, A, additional, Guthrie, L B, additional, Oborn, M, additional, Nor, A Mohd, additional, Hyams, B, additional, Eglinton, C, additional, Waugh, D, additional, Cann, E, additional, Wilmhurst, N, additional, Piesley, S, additional, Shave, S, additional, Dutta, D, additional, Obeid, M, additional, Ward, D, additional, Turfrey, J, additional, Glass, J, additional, Bowstead, K, additional, Hill, L, additional, Brown, P, additional, Beames, S, additional, O'Connell, S, additional, Hughes, V, additional, Whiting, R, additional, Gagg, J, additional, Hussain, M, additional, Harvey, M, additional, Karunatilake, D, additional, Pusuluri, B, additional, Witcher, A, additional, Pawley, C, additional, Allen, J, additional, Foot, J, additional, Rowe, J, additional, Lane, C, additional, Ragab, S, additional, Wadams, B, additional, Dube, J, additional, Jupp, B, additional, Ljubez, A, additional, Bagnall, C, additional, Hann, G, additional, Tucker, L, additional, Kelton, M, additional, Orr, S, additional, Harrington, F, additional, James, A, additional, Lydon, A, additional, Courtauld, G, additional, Bond, K, additional, Lucas, L, additional, Nisbett, T, additional, Kubie, J, additional, Bowring, A, additional, Jennings, G, additional, Thorpe, K, additional, Mason, N, additional, Keenan, S, additional, Gbadomishi, L, additional, Howcroft, D, additional, Newton, H, additional, Choulerton, J, additional, Avis, J, additional, Shaw, L, additional, Paterson, P, additional, Kaye, P, additional, Hierons, S, additional, Lucas, S, additional, Clatworthy, P, additional, Faulkner, B, additional, Rannigan, L, additional, Worner, R, additional, Bhaskaran, B, additional, Saulat, A, additional, Bearne, H, additional, Garfield-Smith, J, additional, Horan, K, additional, Fitzell, P, additional, Szabo, S, additional, Haley, M, additional, Simmons, D, additional, Cotterill, D, additional, Saunders, G, additional, Dymond, H, additional, Beech, S, additional, Rashed, K, additional, Tanate, A, additional, Buckley, C, additional, Wood, D, additional, Matthews, L, additional, Board, S, additional, Pitt-Kirby, T, additional, Rees, N, additional, Convery, C, additional, Jones, P, additional, Bryant, C, additional, Tench, H, additional, Dixon, M, additional, Loosley, R, additional, Coetzee, S, additional, Jones, S, additional, Sims, T, additional, Krishnan, M, additional, Davies, C, additional, Quinn, L, additional, Connor, L, additional, Wani, M, additional, Storton, S, additional, Treadwell, S, additional, Anjum, T, additional, Somashekar, C, additional, Chandler, A, additional, Triscott, C, additional, Bevan, L, additional, Sander, M, additional, Buckle, S, additional, Sayed, W, additional, Andrews, K, additional, Hughes, L, additional, Hughes, R, additional, Ward, M, additional, Pretty, A, additional, Rosser, A, additional, Davidson, B, additional, Price, G, additional, Gunson, I, additional, Lumley-Holmes, J, additional, Miller, J, additional, Larden, M, additional, Jhamat, M, additional, Horwood, P, additional, Boldy, R, additional, Jenkins, C, additional, Price, F, additional, Harrison, M, additional, Martin, T, additional, Ahmad, N, additional, Willberry, A, additional, Stevens, A, additional, Fotherby, K, additional, Barry, A, additional, Remegoso, A, additional, Alipio, F, additional, Maquire, H, additional, Hiden, J, additional, Finney, K, additional, Varquez, R, additional, Ispoglou, S, additional, Hayes, A, additional, Gull, D, additional, Evans, R, additional, Epstein, E, additional, Hurdowar, S, additional, Crossley, J, additional, Miles, J, additional, Hird, K, additional, Pilbery, R, additional, Patterson, C, additional, Ramadan, H, additional, Stewart, K, additional, Quinn, O, additional, Bellfield, R, additional, Macquire, S, additional, Gaba, W, additional, Nair, A, additional, Wilson, A, additional, Hawksworth, C, additional, Alam, I, additional, Greig, J, additional, Gomes, P, additional, Rana, P, additional, Ahmed, Z, additional, Anderston, P, additional, Neal, A, additional, Walstow, D, additional, Fong, R, additional, Brotheridge, S, additional, Bwalya, A, additional, Gillespie, A, additional, Midgley, C, additional, Hare, C, additional, Lyon, H, additional, Stephenson, L, additional, Broome, M, additional, Worton, R, additional, Jackson, S, additional, Rayessa, R, additional, Abdul-Hamid, A, additional, Naylor, C, additional, Clarkson, E, additional, Hassan, A, additional, Veraque, E, additional, Finch, L, additional, Makawa, L, additional, Carpenter, M, additional, Datta, P, additional, Needle, A, additional, Jackson, L, additional, Brooke, H J, additional, Ball, J, additional, Lowry, T, additional, Punnoose, S, additional, Walker, R, additional, Murray, V, additional, Ali, A, additional, Kamara, C, additional, Doyle, C, additional, Richards, E, additional, Howe, J, additional, Dakin, K, additional, Harkness, K, additional, Lindert, R, additional, Wanklyn, P, additional, Willcoxson, P, additional, Clark-Brown, P, additional, and Mir, R, additional

Published
2019
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33. Update on the third international stroke trial (IST-3) of thrombolysis for acute ischaemic stroke and baseline features of the 3035 patients recruited

Author

Sandercock Peter, Lindley Richard, Wardlaw Joanna, Dennis Martin, Innes Karen, Cohen Geoff, Whiteley Will, Perry David, Soosay Vera, Buchanan David, Venables Graham, Czlonkowska Anna, Kobayashi Adam, Berge Eivind, Slot Karsten, Murray Veronica, Peeters Andre, Hankey Graeme J, Matz Karl, Brainin Michael, Ricci Stefano, Cantisani Teresa A, Gubitz Gordon, Phillips Stephen J, Antonio Arauz, Correia Manuel, Lyrer Phillippe, Kane Ingrid, and Lundstrom Erik

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Intravenous recombinant tissue plasminogen activator (rtPA) is approved in Europe for use in patients with acute ischaemic stroke who meet strictly defined criteria. IST-3 sought to improve the external validity and precision of the estimates of the overall treatment effects (efficacy and safety) of rtPA in acute ischaemic stroke, and to determine whether a wider range of patients might benefit. Design International, multi-centre, prospective, randomized, open, blinded endpoint (PROBE) trial of intravenous rtPA in acute ischaemic stroke. Suitable patients had to be assessed and able to start treatment within 6 hours of developing symptoms, and brain imaging must have excluded intracranial haemorrhage and stroke mimics. Results The initial pilot phase was double blind and then, on 01/08/2003, changed to an open design. Recruitment began on 05/05/2000 and closed on 31/07/2011, by which time 3035 patients had been included, only 61 (2%) of whom met the criteria for the 2003 European approval for thrombolysis. 1617 patients were aged over 80 years at trial entry. The analysis plan will be finalised, without reference to the unblinded data, and published before the trial data are unblinded in early 2012. The main trial results will be presented at the European Stroke Conference in Lisbon in May 2012 with the aim to publish simultaneously in a peer-reviewed journal. The trial result will be presented in the context of an updated Cochrane systematic review. We also intend to include the trial data in an individual patient data meta-analysis of all the relevant randomised trials. Conclusion The data from the trial will: improve the external validity and precision of the estimates of the overall treatment effects (efficacy and safety) of iv rtPA in acute ischaemic stroke; provide: new evidence on the balance of risk and benefit of intravenous rtPA among types of patients who do not clearly meet the terms of the current EU approval; and, provide the first large-scale randomised evidence on effects in patients over 80, an age group which had largely been excluded from previous acute stroke trials. Trial registration ISRCTN25765518

Published
2011
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36. The third international stroke trial (IST-3) of thrombolysis for acute ischaemic stroke

Author

Cantisani Teresa, Righetti Enrico, Celani Maria, Ricci Stefano, Brainin Michael, Matz Karl, Hankey Graeme, Peeters Andre, Murray Veronica, Slot Karsten, Berge Eivind, Czlonkowska Anna, Kobayashi Adam, Venables Graham, Lewis Steff, Dennis Martin, Wardlaw Joanna, Lindley Richard, Sandercock Peter, Gubitz Gord, Phillips Steve, Arauz Antonio, Prasad Kameshwar, Correia Manuel, and Lyrer Phillippe

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Intravenous recombinant tissue plasminogen activator (rt-PA) is approved for use in selected patients with ischaemic stroke within 3 hours of symptom onset. IST-3 seeks to determine whether a wider range of patients may benefit. Design International, multi-centre, prospective, randomized, open, blinded endpoint (PROBE) trial of intravenous rt-PA in acute ischaemic stroke. Suitable patients must be assessed and able to start treatment within 6 hours of developing symptoms, and brain imaging must have excluded intracerebral haemorrhage. With 1000 patients, the trial can detect a 7% absolute difference in the primary outcome. With3500 patients, it can detect a 4.0% absolute benefit & with 6000, (mostly treated between 3 & 6 hours), it can detect a 3% benefit. Trial procedures Patients are entered into the trial by telephoning a fast, secure computerised central randomisation system or via a secure web interface. Repeat brain imaging must be performed at 24–48 hours. The scans are reviewed 'blind' by expert readers. The primary measure of outcome is the proportion of patients alive and independent (Modified Rankin 0–2) at six months (assessed via a postal questionnaire mailed directly to the patient). Secondary outcomes include: events within 7 days (death, recurrent stroke, symptomatic intracranial haemorrhage), outcome at six months (death, functional status, EuroQol). Trial registration ISRCTN25765518

Published
2008
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37. 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

Author

Bath, Philip M, Woodhouse, Lisa J, Appleton, Jason P, Beridze, Maia, Christensen, Hanne, Dineen, Robert A, Duley, Lelia, England, Timothy J, Flaherty, Katie, Havard, Diane, Heptinstall, Stan, James, Marilyn, Krishnan, Kailash, Markus, Hugh S, Montgomery, Alan A, Pocock, Stuart J, Randall, Marc, Ranta, Annemarei, Robinson, Thompson G, Scutt, Polly, Venables, Graham S, Sprigg, Nikola, Bath, Philip M, Woodhouse, Lisa J, Appleton, Jason P, Beridze, Maia, Christensen, Hanne, Dineen, Robert A, Duley, Lelia, England, Timothy J, Flaherty, Katie, Havard, Diane, Heptinstall, Stan, James, Marilyn, Krishnan, Kailash, Markus, Hugh S, Montgomery, Alan A, Pocock, Stuart J, Randall, Marc, Ranta, Annemarei, Robinson, Thompson G, Scutt, Polly, Venables, Graham S, and Sprigg, Nikola

Abstract

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 antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy.METHODS: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388.FINDINGS: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67-1·20, p=0·47). By contrast, i

Published
2018

38. Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack:The TARDIS RCT

Author

Bath, Philip M., Woodhouse, Lisa J., Appleton, Jason P., Beridze, Maia, Christensen, Hanne, Dineen, Robert A., Flaherty, Katie, Duley, Lelia, England, Timothy J., Havard, Diane, Heptinstall, Stan, James, Marilyn, Kasonde, Chibeka, Krishnan, Kailash, Markus, Hugh S., Montgomery, Alan A., Pocock, Stuart, Randall, Marc, Ranta, Annamarei, Robinson, Thompson G., Scutt, Polly, Venables, Graham S., Sprigg, Nikola, Bath, Philip M., Woodhouse, Lisa J., Appleton, Jason P., Beridze, Maia, Christensen, Hanne, Dineen, Robert A., Flaherty, Katie, Duley, Lelia, England, Timothy J., Havard, Diane, Heptinstall, Stan, James, Marilyn, Kasonde, Chibeka, Krishnan, Kailash, Markus, Hugh S., Montgomery, Alan A., Pocock, Stuart, Randall, Marc, Ranta, Annamarei, Robinson, Thompson G., Scutt, Polly, Venables, Graham S., and Sprigg, Nikola

Abstract

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 might be better still, providing it does not cause undue bleeding. Objective: To compare the safety and efficacy of intensive therapy with guideline antiplatelet therapy for acute ischaemic stroke and TIA. Design: International prospective randomised open-label blinded end-point parallel-group superiority clinical trial. Setting: Acute hospitals at 106 sites in four countries. Participants: Patients > 50 years of age with acute non-cardioembolic ischaemic stroke or TIA within 48 hours of ictus (stroke). Interventions: Participants were allocated at random by computer to 1 month of intensive (combined aspirin, clopidogrel and dipyridamole) or guideline (combined aspirin and dipyridamole, or clopidogrel alone) antiplatelet agents, and followed for 90 days. Main outcome measures: The primary outcome was the incidence and severity of any recurrent stroke (ischaemic, haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days by blinded telephone follow-up. Analysis using ordinal logistic regression was by intention to treat. Other outcomes included bleeding and its severity, death, myocardial infarction (MI), disability, mood, cognition and quality of life. Results: The trial was stopped early on the recommendation of the Data Monitoring Committee after recruitment of 3096 participants (intensive, n = 1556; guideline, n = 1540) from 106 hospitals in four countries between April 2009 and March 2016. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy in 3070 (99.2%) participants with data [93 vs. 105 stroke/TIA events; adjusted common odds ratio 0.90, 95% confidence interval (CI) 0.67 to 1.20; p = 0.47]. Major (encompassing fatal) bleeding was increased with intensive as compared with guideli

Published
2018

39. Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: the TARDIS RCT

Author

Bath, Philip M, primary, Woodhouse, Lisa J, additional, Appleton, Jason P, additional, Beridze, Maia, additional, Christensen, Hanne, additional, Dineen, Robert A, additional, Flaherty, Katie, additional, Duley, Lelia, additional, England, Timothy J, additional, Havard, Diane, additional, Heptinstall, Stan, additional, James, Marilyn, additional, Kasonde, Chibeka, additional, Krishnan, Kailash, additional, Markus, Hugh S, additional, Montgomery, Alan A, additional, Pocock, Stuart, additional, Randall, Marc, additional, Ranta, Annamarei, additional, Robinson, Thompson G, additional, Scutt, Polly, additional, Venables, Graham S, additional, and Sprigg, Nikola, additional

Published
2018
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40. Restenosis and risk of stroke after stenting or endarterectomy for symptomatic carotid stenosis in the International Carotid Stenting Study (ICSS): secondary analysis of a randomised trial

Author

Bonati, Leo H, primary, Gregson, John, additional, Dobson, Joanna, additional, McCabe, Dominick J H, additional, Nederkoorn, Paul J, additional, van der Worp, H Bart, additional, de Borst, Gert J, additional, Richards, Toby, additional, Cleveland, Trevor, additional, Müller, Mandy D, additional, Wolff, Thomas, additional, Engelter, Stefan T, additional, Lyrer, Philippe A, additional, Brown, Martin M, additional, Algra, Ale, additional, Bakke, S J, additional, Baldwin, Neil, additional, Beard, Jonathan, additional, Bladin, Christopher, additional, Bland, J Martin, additional, Boiten, J, additional, Bosiers, Mark, additional, Bradbury, A W, additional, Canovas, David, additional, Chambers, Brian, additional, Chamorro, Angel, additional, Chataway, Jonathan, additional, Clifton, Andrew, additional, Collins, Rory, additional, Coward, Lucy, additional, Czlonkowska, Anna, additional, Davis, Stephen, additional, DeJaegher, L, additional, Doig, David, additional, Dorman, Paul, additional, Ederle, Jörg, additional, Featherstone, Roland F, additional, Ferro, Jose M, additional, Gaines, Peter, additional, Gilling-Smith, G, additional, Goertler, M, additional, Gottsäter, A, additional, Hacke, Werne, additional, Halliday, Alison, additional, Hamilton, George, additional, Hendriks, J M H, additional, Hill, Michael, additional, Kapelle, L Jaap, additional, Kaste, Markku, additional, Kennedy, Fiona, additional, Konrad, P, additional, Kool, LJS, additional, Koudstaal, Peter J, additional, Malik, I, additional, Markus, Hugh, additional, Martin, Peter, additional, Mas, Jean-Louis, additional, McCollum, Charles, additional, McGahan, T, additional, McGuire, A J, additional, Michel, Philippe, additional, Molyneux, Andrew, additional, Moroney, Jane, additional, Mosch, A, additional, Moss, J, additional, Naylor, Ross, additional, Peeters, A, additional, Roy, D, additional, Schultz, David, additional, Seriki, D M, additional, Shinton, R A, additional, Sidhu, Paul, additional, Stewart, J, additional, Subramanian, G, additional, Sztajzel, R, additional, Than, P G, additional, Thomas, Daffyd, additional, Turner, E, additional, van den Berg, J S P, additional, Vanhooren, G, additional, Venables, Graham, additional, Wahlgren, Nils, additional, Walker, S, additional, Warlow, Charles, additional, and Zvan, Bojana, additional

Published
2018
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41. 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

Author

Bath, Philip M, primary, Woodhouse, Lisa J, additional, Appleton, Jason P, additional, Beridze, Maia, additional, Christensen, Hanne, additional, Dineen, Robert A, additional, Duley, Lelia, additional, England, Timothy J, additional, Flaherty, Katie, additional, Havard, Diane, additional, Heptinstall, Stan, additional, James, Marilyn, additional, Krishnan, Kailash, additional, Markus, Hugh S, additional, Montgomery, Alan A, additional, Pocock, Stuart J, additional, Randall, Marc, additional, Ranta, Annemarei, additional, Robinson, Thompson G, additional, Scutt, Polly, additional, Venables, Graham S, additional, Sprigg, Nikola, additional, Christensen, L M, additional, Bentsen, L, additional, Krarup Hansen, C, additional, Thomsen, T T, additional, Kruuse, C, additional, Jensen, H H, additional, Hansen, S S, additional, Petrovic, V, additional, Beridze, N, additional, Kakabadze, N, additional, Kherkheulidze, T, additional, Kakabadze, D, additional, Toidze, I, additional, Lobjanidze, N, additional, Akiashvili, N, additional, Tevdoradze, A, additional, Khizanishvili, N, additional, Tsanava, T, additional, Taylor, R, additional, Iniesta, I, additional, Kok, J, additional, Duignan, J, additional, Funnell, M, additional, Cariga, P, additional, Rodriguez, M, additional, Watson, I J, additional, Tennant, S, additional, Macleod, M, additional, Furnace, J, additional, Gow, H, additional, Irvine, J, additional, Joyson, A, additional, Nelson, S, additional, Taylor, V, additional, Smith, M, additional, Bellfield, R, additional, Hairsine, B, additional, Davies, R, additional, Dodd, A, additional, Corrigan, J, additional, Doherty, M, additional, Ahmed, A, additional, Denniss, C, additional, Johnson-Holland, S, additional, Kay, K A, additional, Palau, R Icart, additional, Auld, G, additional, Daboo, P, additional, Erande, R, additional, Grimwood, G, additional, Hove, D, additional, Howaniec, L, additional, Redjep, O, additional, Rangasamay, R, additional, Butt, G, additional, Sandler, D, additional, Reddan, J, additional, Stafford, S, additional, McIlmoyle, J, additional, Maguire, S, additional, Murphy, P, additional, Chambers, J, additional, Guthrie, L, additional, Osborn, M, additional, Steele, A, additional, Burn, M, additional, Benford, A, additional, Misra, A, additional, Hilton, D, additional, O'Brien, E, additional, Amis, E, additional, Finlay, S, additional, Mitchell, J, additional, Geraghty, O, additional, Harvey, K, additional, Hazel, B, additional, Mashate, S, additional, Wilding, P, additional, Sajid, M, additional, Ball, M, additional, Gascoyne, R, additional, Sivakumar, R, additional, Wright, A, additional, Chatterjee, K, additional, Booth, S, additional, Eccleson, H, additional, Kelly, C, additional, Leason, S, additional, Perkins, C, additional, Bruce, D, additional, Brown, E, additional, Clayton, S, additional, Garside, M, additional, Rogers, G, additional, Lawrence, E, additional, Mahmood, S, additional, Watchurst, C, additional, Chadha, D, additional, Glover, L, additional, Holford, L, additional, Smith, K, additional, Walstow, D, additional, Williams, R, additional, O'Shea, L, additional, Goodsell, J, additional, Athulathmudali, C, additional, Barbon, E, additional, Namushi, R, additional, Jacob, P, additional, Johnson, L, additional, Morse, D, additional, McGhee, C, additional, Speirs, O, additional, Atkinson, S, additional, Peacocke, A, additional, Langhorne, P, additional, Graham, R, additional, Wright, F, additional, McAlpine, C, additional, Ravindrane, A, additional, Bajoriene, M, additional, Matter, L, additional, Windebank, S, additional, Giallombardo, E, additional, Dellafera, D, additional, Eglinton, C, additional, Wilson, J, additional, Broughton, D, additional, Chapman, K, additional, Dixon, L, additional, Zaidi, M, additional, Ayes, K, additional, Kessell, J, additional, Manawadu, D, additional, Adegbaju, O, additional, Aeron-Thomas, J, additional, Anderson, K, additional, Brigden, A, additional, Cattermole, E, additional, Good, J, additional, Hassan, S, additional, Khoromana, E, additional, Lee-Carbon, L, additional, Marks, K, additional, Mckenzie, E, additional, Sikondari, N, additional, Cooper, M, additional, Whysall, K, additional, Wynter, I, additional, Bamford, J, additional, Hassan, A, additional, Wanklyn, P, additional, Kambafwile, M, additional, Makawa, L, additional, Waugh, D, additional, Veraque, E, additional, Soliman, MGG, additional, Arif, S, additional, Brown, R, additional, Butler, S, additional, Hewitt, C, additional, Hindle, J, additional, Pusalkar, A, additional, Beadle, H, additional, Chan, K, additional, Siddiqui, M, additional, Dangri, P, additional, Buddha, S, additional, Asokanathan, A, additional, Mistri, A, additional, Eveson, D, additional, Musarrat, K, additional, Manning, L, additional, Anand, S, additional, Christian, P, additional, Khan, S, additional, Patel, C, additional, Sein, M, additional, Banns, J, additional, Gibson, E, additional, Gordon, T, additional, Gruenbeck, Y, additional, Wong, S, additional, Datta, P, additional, Bateman, G, additional, Jackson, L, additional, Needle, A, additional, Duodu, Y, additional, Oliver, R, additional, Padilla-Harris, C, additional, Barber, M, additional, Esson, D, additional, Brodie, F, additional, McInnes, C, additional, Fotherby, K, additional, Butler, D, additional, Morgan, D, additional, Preece, K, additional, Willberry, A, additional, Dent, M, additional, Hammonds, F, additional, Hunt, J, additional, Vernon, C, additional, O'Kane, D, additional, Faola, F, additional, Lai, P, additional, O'Callaghan, J, additional, Smith, C, additional, Price, C, additional, Lakey, R, additional, Riddell, V, additional, Smith, A, additional, Storey, G, additional, Munshi, S, additional, Buck, A, additional, Clarke, J, additional, Gilzeane, N, additional, Godfrey, M, additional, Keshvara, R, additional, Richardson, C, additional, Roffe, J, additional, Ryan, L, additional, Shelton, F, additional, Sunman, W, additional, Tittle, A, additional, Tomlinson, J, additional, Whittamore, K, additional, Wilkes, G, additional, Owusu-Agyei, P, additional, Temple, N, additional, Mangion, D, additional, Hardwick, A, additional, Netherton, K, additional, Nor, A Mohd, additional, Hyams, B, additional, Norman, S, additional, Persad, N, additional, Ragab, S, additional, Dickson, C, additional, Dube, J, additional, Jinks, E, additional, Knops, K, additional, Wadams, B, additional, Ali, K, additional, Gaylard, J, additional, Spurling, G, additional, Sztriha, L, additional, Ajao, T, additional, Alao, M, additional, Chan, F K, additional, Webster, P, additional, Howard, P, additional, Dobson, T J, additional, Hyatt, L, additional, Sims, D, additional, Cunningham, J, additional, Esisi, B, additional, Cassidy, T, additional, Bokhari, M, additional, McClelland, B, additional, Mokoena, B, additional, Gunathilagan, G, additional, Jones, S, additional, Reader, M, additional, Thomas, G, additional, Tilby, S, additional, Findlay, P, additional, Barrett, F, additional, Leslie, F, additional, Ross, S, additional, Shread, I, additional, Okwera, J, additional, Howe, J, additional, Harrington, F, additional, Courtauld, G, additional, Schofield, C, additional, Donnelly, R, additional, Maddula, M, additional, Scott, J, additional, Beavan, J, additional, Muhidden, K, additional, Memon, I, additional, Clarke, M, additional, Hedstrom, A, additional, Mills, L, additional, Hemsley, A, additional, Bowring, A, additional, Boxall, L, additional, Kingwell, H, additional, Keenan, S, additional, Roughan, C, additional, Manoj, A, additional, Cox, P, additional, Fletcher, G, additional, Lopez, P, additional, Emsley, H, additional, Gregary, B, additional, McLoughlin, A, additional, Raj, S, additional, Roffe, C, additional, Abano, N, additional, Barry, A, additional, Butler, A, additional, Carpio, R, additional, Castro, K, additional, Finney, K, additional, Gomm, S, additional, Hiden, J, additional, Grocott, J, additional, Lyjko, S, additional, Maguire, H, additional, Remegoso, A, additional, Sanyal, R, additional, Stevens, S, additional, Natarajan, I, additional, Chembala, J, additional, Muddegowda, G, additional, Warusevitane, A, additional, Blight, A, additional, Balazikova, O, additional, Lawlor, C, additional, Shaw, L, additional, Button, D, additional, Howcroft, D, additional, Lucas, S, additional, Madigan, B, additional, McCann, S, additional, Dixit, A, additional, Barkat, A, additional, Davis, J, additional, Fawcett, M, additional, Finlay, L, additional, Guy, H, additional, Hays, C, additional, Hogg, V, additional, Horsley, E, additional, Hubbuck, C, additional, Pringle, C, additional, Stevenson, C, additional, Storey, K, additional, Thompson, T, additional, Woodward, S, additional, Banerjee, A, additional, Allcock, C, additional, Merotra, S, additional, Douglass, C, additional, Campbell, E, additional, Jarapa, R, additional, Johnes, M, additional, Keaveney, C, additional, Marsden, T, additional, Naing, Z, additional, Perez, J, additional, Shaw, K, additional, Black, T, additional, Anthony, A, additional, Clarke, C, additional, Paterson, J, additional, Deighton, K, additional, Temlett, E, additional, Blank, C, additional, Doyle, C, additional, Duty, S, additional, Gill, K, additional, Harkness, K, additional, Kamara, C, additional, Richards, E, additional, Elfandi, K, additional, Guyler, P, additional, Harman, P, additional, Khuoge, C, additional, Kunhunny, S, additional, Tysoe, S, additional, Moynihan, B, additional, Adedoyin, T, additional, Chopra, N, additional, Dayal, N, additional, Ghatala, R, additional, Jeyaraj, N, additional, Jones, I, additional, Kennedy, F, additional, Kerin, L, additional, Khanom, N, additional, Lewis, S, additional, Maheswaran, S, additional, Montague, L, additional, Niemierko, M, additional, O'Reilly, J, additional, Trippier, S, additional, Watson, F, additional, Wilkinson, P, additional, Young, E, additional, Dizayee, K, additional, Cochrane, H, additional, O'Connell, J, additional, Mokoena, L, additional, Osborne, E, additional, Nair, A, additional, Greig, J, additional, Jenkins, C, additional, Powell, J, additional, Price, F, additional, Chowdhury, M, additional, Brixey, S, additional, Hunt, L, additional, Rands, N, additional, Rose, G, additional, Stoddart, S, additional, Srinivasan, M, additional, Motherwell, N, additional, Shekhar, R, additional, Fuller, T, additional, Lankester, A, additional, Lingwood, P, additional, Rankin, C, additional, Webb, H, additional, Jupp, B, additional, Bell, J, additional, Hann, G, additional, Longland, B, additional, Ovington, C, additional, Bhaskaran, B, additional, Ayres, G, additional, Bailey, C, additional, Bearne, H, additional, Buxton, J, additional, Fitzell, P, additional, Hilaire, C, additional, Kelly, D, additional, Szabo, S, additional, Tomlin, D, additional, Gamble, E, additional, Charles, B, additional, Kumar, R, additional, Fluskey, T, additional, Mellor, Z, additional, Peters, J, additional, Sutton, V, additional, Kenton, A, additional, Martin, I, additional, Nyabadza, S, additional, Ghosh, S, additional, Henry, M, additional, Kumar, B, additional, Ambulo, C, additional, Crawford, S, additional, Nozedar, T, additional, Platton, M, additional, Cvoro, V, additional, Couser, M, additional, McCormick, K, additional, Wilkinson, D, additional, Javaid, K, additional, Hurdowar, S, additional, Attygalle, T, additional, Sundayi, S, additional, Orugun, O, additional, Crowther, H, additional, Jolly, R, additional, Poultney, U, additional, Azim, A, additional, Krasinska-Chavez, M, additional, White, J, additional, Sengupta, N, additional, Margalef, J, additional, Metiu, M G, additional, Meenakshisundaram, S, additional, Dealing, S, additional, Hargroves, D, additional, Beranova, E, additional, Cowie, L, additional, Rudenko, H, additional, Thomson, A, additional, Verrion, A, additional, Rashed, K, additional, Board, S, additional, Buckley, C, additional, Hayward, D, additional, Jenkins, K, additional, Keeling, E, additional, Rowland-Axe, R, additional, Vickers, C, additional, Wood, D, additional, Lehman, A, additional, Patel, M, additional, Russell, H, additional, Rehman, H, additional, Forrest, D, additional, and Farren, P, additional

Published
2018
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43. The Hillsborough Tragedy

Author

Wardrope, James, Ryan, Frank, Clark, George, Venables, Graham, Crosby, A. Courtney, and Redgrave, Paul

Published
1991

44. Baseline characteristics of the 3096 patients recruited into the 'Triple Antiplatelets for Reducing Dependency after Ischemic Stroke' trial

Author

Bath, Philip Mw, Appleton, Jason P, Beridze, Maia, Christensen, Hanne, Dineen, Robert A, Duley, Lelia, England, Timothy J, Heptinstall, Stan, James, Marilyn, Krishnan, Kailash, Markus, Hugh S, Pocock, Stuart, Ranta, Annemarei, Robinson, Thompson G, Flaherty, Katie, Scutt, Polly, Venables, Graham S, Woodhouse, Lisa J, Sprigg, Nikola, Bath, Philip Mw, Appleton, Jason P, Beridze, Maia, Christensen, Hanne, Dineen, Robert A, Duley, Lelia, England, Timothy J, Heptinstall, Stan, James, Marilyn, Krishnan, Kailash, Markus, Hugh S, Pocock, Stuart, Ranta, Annemarei, Robinson, Thompson G, Flaherty, Katie, Scutt, Polly, Venables, Graham S, Woodhouse, Lisa J, and Sprigg, Nikola

Abstract

Background The risk of recurrence following ischemic stroke or transient ischemic attack is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in the early phase after ictus. Design The triple antiplatelets for reducing dependency after ischemic stroke trial was an international multicenter prospective randomized open-label blinded-endpoint trial that assessed the safety and efficacy of short-term intensive antiplatelet therapy with three agents (combined aspirin, clopidogrel and dipyridamole) as compared with guideline treatment in acute ischemic stroke or transient ischemic attack. The primary outcome was stroke recurrence and its severity, measured using the modified Rankin Scale at 90 days. Secondary outcomes included recurrent vascular events, functional measures (cognition, disability, mood, quality of life), and safety (bleeding, death, serious adverse events). Data are number (%) or mean (standard deviation, SD). Results Recruitment ran from April 2009 to March 2016; 3096 patients were recruited from 106 sites in four countries (Denmark 1.6%, Georgia 2.7%, New Zealand 0.2%, UK 95.4%). Randomization characteristics included: age 69.0 (10.1) years; male 1945 (62.8%); time onset to randomization 29.4 (11.9) h; stroke severity (National Institutes for Health Stroke Scale) 2.8 (3.6); blood pressure 143.5 (18.2)/79.5 (11.4) mmHg; IS 2143 (69.2%), transient ischemic attack 953 (30.8%). Conclusion Triple antiplatelets for reducing dependency after ischemic stroke was a large trial of intensive/triple antiplatelet therapy in acute ischemic stroke and transient ischemic attack, and included participants from four predominantly Caucasian countries who were representative of patients in many western stroke services.

Published
2017

46. Abstract WP76: Baseline Characteristics of the 3,096 Patients Recruited Into the ‘Triple Antiplatelets for Reducing Dependency After Ischaemic Stroke’ (TARDIS) Trial

Author

Bath, Philip M, primary, Appleton, Jason P, additional, Beridze, Maia, additional, Christensen, Hanne, additional, Dineen, Robert A, additional, Duley, Lelia, additional, England, Timothy J, additional, Heptinstall, Stan, additional, James, Marilyn, additional, Krishnan, Kailash, additional, Markus, Hugh S, additional, Pocock, Stuart, additional, Ranta, Annemarei, additional, Robinson, Thompson, additional, Flaherty, Katie, additional, Scutt, Polly, additional, Venables, Graham S, additional, Woodhouse, Lisa, additional, and Sprigg, Nikola, additional

Published
2017
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47. Baseline characteristics of the 3096 patients recruited into the ‘Triple Antiplatelets for Reducing Dependency after Ischemic Stroke’ trial

Author

Bath, Philip MW, primary, Appleton, Jason P, additional, Beridze, Maia, additional, Christensen, Hanne, additional, Dineen, Robert A, additional, Duley, Lelia, additional, England, Timothy J, additional, Heptinstall, Stan, additional, James, Marilyn, additional, Krishnan, Kailash, additional, Markus, Hugh S, additional, Pocock, Stuart, additional, Ranta, Annemarei, additional, Robinson, Thompson G, additional, Flaherty, Katie, additional, Scutt, Polly, additional, Venables, Graham S, additional, Woodhouse, Lisa J, additional, and Sprigg, Nikola, additional

Published
2016
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48. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial

Author

CADISS trial investigators, Markus, Hugh S, Hayter, Elizabeth, Levi, Christopher, Feldman, Adina, Venables, Graham, Norris, John, and Apollo - University of Cambridge Repository

Subjects
Adult, Male, Anticoagulants, Arteries, Carotid Artery, Internal, Dissection, Middle Aged, Subarachnoid Hemorrhage, Spine, Stroke, Aortic Dissection, Ischemic Attack, Transient, Odds Ratio, Humans, Female, cardiovascular diseases, Platelet Aggregation Inhibitors, Aged
Abstract

BACKGROUND: Extracranial carotid and vertebral artery dissection is an important cause of stroke, especially in young people. In some observational studies it has been associated with a high risk of recurrent stroke. Both antiplatelet drugs and anticoagulant drugs are used to reduce risk of stroke but whether one treatment strategy is more effective than the other is unknown. We compared their efficacy in the Cervical Artery Dissection in Stroke Study (CADISS), with the additional aim of establishing the true risk of recurrent stroke. METHODS: We did this randomised trial at hospitals with specialised stroke or neurology services (39 in the UK and seven in Australia). We included patients with extracranial carotid and vertebral dissection with onset of symptoms within the past 7 days. Patients were randomly assigned (1:1) by an automated telephone randomisation service to receive antiplatelet drugs or anticoagulant drugs (specific treatment decided by the local clinician) for 3 months. Patients and clinicians were not masked to allocation, but investigators assessing endpoints were. The primary endpoint was ipsilateral stroke or death in the intention-to-treat population. The trial was registered with EUDract (2006-002827-18) and ISRN (CTN44555237). FINDINGS: We enrolled 250 participants (118 carotid, 132 vertebral). Mean time to randomisation was 3·65 days (SD 1·91). The major presenting symptoms were stroke or transient ischaemic attack (n=224) and local symptoms (headache, neck pain, or Horner's syndrome; n=26). 126 participants were assigned to antiplatelet treatment versus 124 to anticoagulant treatment. Overall, four (2%) of 250 patients had stroke recurrence (all ipsilateral). Stroke or death occurred in three (2%) of 126 patients versus one (1%) of 124 (odds ratio [OR] 0·335, 95% CI 0·006-4·233; p=0·63). There were no deaths, but one major bleeding (subarachnoid haemorrhage) in the anticoagulant group. Central review of imaging failed to confirm dissection in 52 patients. Preplanned per-protocol analysis excluding these patients showed stroke or death in three (3%) of 101 patients in the antiplatelet group versus one (1%) of 96 patients in the anticoagulant group (OR 0·346, 95% CI 0·006-4·390; p=0·66). INTERPRETATION: We found no difference in efficacy of antiplatelet and anticoagulant drugs at preventing stroke and death in patients with symptomatic carotid and vertebral artery dissection but stroke was rare in both groups, and much rarer than reported in some observational studies. Diagnosis of dissection was not confirmed after review in many cases, suggesting that radiographic criteria are not always correctly applied in routine clinical practice. FUNDING: Stroke Association.

Published
2015

49. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS):a randomised trial

Author

Markus, Hugh S., Hayter, Elizabeth, Levi, Christopher, Feldman, Adina, Venables, Graham, Norris, John, Emsley, Hedley, CADISS trial investigators, Markus, Hugh S., Hayter, Elizabeth, Levi, Christopher, Feldman, Adina, Venables, Graham, Norris, John, Emsley, Hedley, and CADISS trial investigators

Abstract

BACKGROUND: Extracranial carotid and vertebral artery dissection is an important cause of stroke, especially in young people. In some observational studies it has been associated with a high risk of recurrent stroke. Both antiplatelet drugs and anticoagulant drugs are used to reduce risk of stroke but whether one treatment strategy is more effective than the other is unknown. We compared their efficacy in the Cervical Artery Dissection in Stroke Study (CADISS), with the additional aim of establishing the true risk of recurrent stroke. METHODS: We did this randomised trial at hospitals with specialised stroke or neurology services (39 in the UK and seven in Australia). We included patients with extracranial carotid and vertebral dissection with onset of symptoms within the past 7 days. Patients were randomly assigned (1:1) by an automated telephone randomisation service to receive antiplatelet drugs or anticoagulant drugs (specific treatment decided by the local clinician) for 3 months. Patients and clinicians were not masked to allocation, but investigators assessing endpoints were. The primary endpoint was ipsilateral stroke or death in the intention-to-treat population. The trial was registered with EUDract (2006-002827-18) and ISRN (CTN44555237). FINDINGS: We enrolled 250 participants (118 carotid, 132 vertebral). Mean time to randomisation was 3·65 days (SD 1·91). The major presenting symptoms were stroke or transient ischaemic attack (n=224) and local symptoms (headache, neck pain, or Horner's syndrome; n=26). 126 participants were assigned to antiplatelet treatment versus 124 to anticoagulant treatment. Overall, four (2%) of 250 patients had stroke recurrence (all ipsilateral). Stroke or death occurred in three (2%) of 126 patients versus one (1%) of 124 (odds ratio [OR] 0·335, 95% CI 0·006-4·233; p=0·63). There were no deaths, but one major bleeding (subarachnoid haemorrhage) in the anticoagulant group. Central review of imaging failed to confirm dissection i

Published
2015

50. EPITHET--where next?

Author

Sandercock Peter, Wardlaw Joanna, Dennis Martin, Lindley Richard, Hankey Graeme, Matz Karl, Peeters Andre, Phillips Stephen, Gubitz Gord, Prasad Kameshwar, Ricci Stefano, Celani Maria Grazia, Righetti Enrico, Cantisani Theresa, Arauz Antonio, Berge Eivind, Slot Karsten Bruins, Kobayashi Adam, Czlonkowska Anna, Correia Manuel, Murray Veronica, Lyrer Philippe, Venables Graham, and IST-3 Collaborative Group

Subjects
Echo-planar imaging, medicine.medical_specialty, business.industry, media_common.quotation_subject, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, medicine, Physical therapy, 030212 general & internal medicine, Neurology (clinical), Epithet, Intensive care medicine, business, Stroke, 030217 neurology & neurosurgery, media_common
Abstract

Comment on EPITHET: failed chance or new hope? Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial.

Published
2008
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