Evidence map›Paper›PMID 37564156›Full record

ArticleBMJ neurology open2023

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial.

Lisa J Woodhouse, Jason P Appleton, Sandeep Ankolekar, Timothy J England, Grant Mair, Keith Muir, Christopher I Price, Stuart Pocock, Marc Randall, Thompson G Robinson and 8 more

Open access · diamondAbstract read
In one paragraph

Article in BMJ neurology open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 34% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. 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

18 authors at 14 institutions in 3 countries.

Lisa J WoodhouseStroke Trials Unit, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-4472-1999
Jason P AppletonStroke, Nottingham University Hospitals NHS Trust, Nottingham, UK.ORCID 0000-0002-2604-4410
Sandeep AnkolekarDepartment of Neurology, King's College Hospital NHS Trust, London, UK.
Timothy J EnglandVascular Medicine, Division of Medical Sciences and GEM, Royal Derby Hospital, Derby, UK.
Grant MairUK Dementia Research Institute, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK.
Keith MuirNeurology, University of Glasgow, Glasgow, UK.
Christopher I PriceInstitute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
Stuart PocockDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
Marc RandallDepartment of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Thompson G RobinsonDepartment of Cardiovascular Sciences, and NIHR Biomedical Research Unit for Cardiovascular Diseases, University of Leicester, Leicester, UK.
Christine RoffeInstitute for Science and Technology in Medicine, Keele University, Keele, UK.
Else C SandsetDepartment of Neurology, Oslo University Hospital, Oslo, Norway.
Jeffrey L SaverDepartment of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, Los Angeles, California, USA.
Aloysius Niroshan SiriwardenaCommunity and Health Research Unit, University of Lincoln, Lincoln, UK.ORCID 0000-0003-2484-8201
Nikola SpriggStroke Trials Unit, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
Joanna M WardlawUK Dementia Research Institute, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK.
Philip M BathStroke Trials Unit, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
RIGHT-2 Investigators
Nottingham University Hospitals NHS Trust · GBUK Dementia Research Institute · GBKeele University · GBKing's College Hospital · GBLeeds Teaching Hospitals NHS Trust · GBLondon School of Hygiene & Tropical Medicine · GBNewcastle University · GBOslo University Hospital · NORoyal Derby Hospital · GBUniversity of California, Los Angeles · USUniversity of Glasgow · GBUniversity of Leicester · GBUniversity of Lincoln · GBUniversity of Nottingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2) reported no overall treatment difference between glyceryl trinitrate (GTN) and sham at day 90. Here we assess participants' outcomes 1 year after randomisation. Methods: RIGHT-2 was an ambulance-based prospective randomised controlled trial where patients with presumed stroke and systolic blood pressure (BP) of >120 mm Hg received either GTN (5 mg/day) or sham patch. Centralised blinded telephone follow-up was performed at days 90 (primary endpoint) and 365 (secondary endpoint). The lead outcome was dependency assessed with the modified Rankin Scale (mRS). Results: 1149 patients were recruited to RIGHT-2 between October 2015 and May 2018, and 1097 (95.5%) had outcome data recorded at day 365. At baseline, the patients were; female (48%), had a mean age of 73 (15) years, BP of 162 (25)/92 (18) mm Hg, onset to randomisation of 70 (45-115) min, diagnosis of ischaemic stroke (52%), intracerebral haemorrhage (ICH) (13%), transient ischaemic attack (TIA) (9%) and mimics (26%). There was no effect of GTN on mRS score at day 365 in participants with confirmed stroke/TIA (adjusted common odds ratio (acOR) 1.10, 95% CI 0.86 to 1.42) or in all patients. In patients randomised to GTN, mRS at day 365 tended to be worse in those with ICH (acOR 1.65, 95% CI 0.84 to 3.25) and better in those with a mimic diagnosis (acOR 0.53, 95% CI 0.33 to 0.84). Conclusion: At 1 year post randomisation, dependency did not differ between GTN and sham treatment in either the target population or overall. In prespecified subgroup analyses, GTN was associated with reduced dependency in participants with a final diagnosis of mimic and a non-significant worse outcome in participants with ICH. Trial registration number: ISRCTN26986053.

Indexed as

CEREBRAL BLOOD FLOWCEREBROVASCULAR DISEASERANDOMISED TRIALSSTROKE

Identifiers

PMID37564156
PMCPMC10410995
OpenAlexW4382457723

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.