Evidence map›Paper›PMID 27190674›Full record

ArticleStroke research and treatment2016

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.

Philip M Bath, Lisa Woodhouse, Kailash Krishnan, Craig Anderson, Eivind Berge, Gary A Ford, Thompson G Robinson, Jeffrey L Saver, Nikola Sprigg, Joanna M Wardlaw and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke research and treatment, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
3.6field-weighted citation impact, top 7% of its field
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

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Guideline
  2. Pooled it
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  4. Pooled it
  5. Trial
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  10. The hazards of chasing subgroups in neutral stroke trials.Neurological research and practice · 2025
    Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Fourth European stroke science workshop.European stroke journal · 2018
    Article
  16. Article
  17. Review
  18. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 4 countries.

Philip M BathStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham NG5 1PB, UK.
Lisa WoodhouseStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham NG5 1PB, UK.
Kailash KrishnanStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham NG5 1PB, UK.
Craig AndersonNeurological & Mental Health Division, University of Sydney, Sydney, NSW 2000, Australia.
Eivind BergeDepartment of Internal Medicine, Oslo University Hospital, 0424 Oslo, Norway.
Gary A FordOxford Academic Health Sciences Network, Oxford University Hospitals, NHS Trust, Oxford OX4 4GA, UK.
Thompson G RobinsonDepartment of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Disease, University of Leicester, Leicester LE3 9QP, UK.
Jeffrey L SaverGeffen School of Medicine at UCLA, UCLA Comprehensive Stroke Center, Los Angeles, CA 90095, USA.
Nikola SpriggStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham NG5 1PB, UK.
Joanna M WardlawDivision of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK.
Blood Pressure In Acute Stroke Collaboration BascUniversity of Nottingham, Nottingham NG5 1PB, UK.
University of Nottingham · GBNIHR Leicester Cardiovascular Biomedical Research Unit · GBOslo University Hospital · NOOxford University Hospitals NHS Trust · GBUCLA Health · USUniversity of Edinburgh · GBUniversity of Sydney · AU

Funding

Medical Research Council G0501797Medical Research Council MR/K026992/1
6 · The paper itself

Abstract

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.

Identifiers

PMID27190674
PMCPMC4852111
OpenAlexW2338716492

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.