Evidence map›Paper›PMID 12519542›Full record

SynthesisThe Cochrane database of systematic reviews2002

Nitric oxide donors (nitrates), L-arginine, or nitric oxide synthase inhibitors for acute stroke.

P M Bath, M Willmot, J Leonardi-Bee, F J Bath

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Cerebrolysin for acute ischaemic stroke.The Cochrane database of systematic reviews · 2017
    Pooled it
  2. Pooled it
  3. Cerebrolysin for acute ischaemic stroke.The Cochrane database of systematic reviews · 2016
    Pooled it
  4. Interventions for deliberately altering blood pressure in acute stroke.The Cochrane database of systematic reviews · 2014
    Pooled it
  5. Vasoactive drugs for acute stroke.The Cochrane database of systematic reviews · 2010
    Pooled it
  6. Pooled it
  7. Trial
  8. Extremely low frequency electromagnetic stimulation reduces ischemic stroke volume by improving cerebral collateral blood flow.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2022
    Article
  9. Nitric oxide inhalation reduces brain damage, prevents mortality, and improves neurological outcome after subarachnoid hemorrhage by resolving early pial microvasospasms.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2016
    Article
  10. Review
  11. Review
  12. Nitric oxide: considerations for the treatment of ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2012
    Review
  13. Stroke management.Annals of Indian Academy of Neurology · 2011
    Article
  14. Blood pressure management in acute stroke.Journal of human hypertension · 2009
    Review
  15. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

P M BathDivision of Stroke Medicine, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, Nottinghamshire, UK, NG5 1PB. philip.bath@nottingham.ac.uk
M Willmot
J Leonardi-Bee
F J Bath

Funding

Medical Research Council G0501797
6 · The paper itself

Abstract

backgroundNitric oxide has several effects that may be beneficial in ischaemic stroke and useful in the management of high blood pressure in acute stroke. Some forms of nitric oxide synthase inhibition may also be beneficial. However, high concentrations of nitric oxide are likely to be toxic to brain tissue.

objectivesThe objective of this review was to assess the effects of nitric oxide donors, L-arginine, or nitric oxide synthase-inhibitors in people with acute stroke. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched in March 2002), EMBASE (1980-March 2002), MEDLINE (1966-March 2002), and ISI Science Citation Indexes (1981-March 2002). We contacted drug companies and researchers in the field. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing nitric oxide donors, L-arginine, or nitric oxide synthase-inhibitors in patients within one week of onset of confirmed stroke. DATA COLLECTION AND ANALYSIS: Two reviewers independently applied the inclusion criteria. The data are given as weighted mean difference (WMD) or odds ratio (OR) with 95% confidence intervals (CI). MAIN

resultsTwo small completed trials (127 patients) of transdermal glyceryl trinitrate (GTN), a nitric oxide donor, were found. GTN lowered 24 hour ambulatory systolic blood pressure by 7.9 mmHg (95% CI 0.1, 15.8) and increased heart rate (WMD 6.2 beats per minute, 95% CI 2.7, 9.8). Treatment with GTN was not associated with statistically significant effects on end-of-treatment death, or combined death or deterioration, or end-of-trial death, combined death or dependency, or combined death or institutionalisation. REVIEWER'S

conclusionsThere is currently insufficient evidence from randomised trials on the effects of nitric oxide donors, L-arginine, or nitric oxide synthase-inhibitors in patients with acute stroke to recommend their use. A large controlled trial of glyceryl trinitrate patches is underway.

Indexed as

ArginineBrain IschemiaEnzyme InhibitorsHumansNitric Oxide DonorsNitric Oxide SynthaseStrokeArginineEnzyme InhibitorsNitric Oxide DonorsNitric Oxide Synthase

Identifiers

PMID12519542

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.