Glyceryl Trinitrate for Acute Intracerebral Hemorrhage Results From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial, a Subgroup Analysis

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dc.contributor.authorKrishnan, Kailash
dc.contributor.authorScutt, Polly
dc.contributor.authorWoodhouse, Lisa
dc.contributor.authorAdami, Alessandro
dc.contributor.authorBecker, Jennifer L.
dc.contributor.authorBerge, Eivind
dc.contributor.authorCala, Lesley A.
dc.date.accessioned2020-03-26T19:24:24Z
dc.date.available2020-03-26T19:24:24Z
dc.date.issued2016
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractBackground and Purpose The Efficacy of Nitric Oxide in Stroke (ENOS) trial found that transdermal glyceryl trinitrate (GTN, a nitric oxide donor) lowered blood pressure but did not improve functional outcome in patients with acute stroke. However, GTN was associated with improved outcome if patients were randomized within 6 hours of stroke onset. Methods In this prespecified subgroup analysis, the effect of GTN (5 mg/d for 7 days) versus no GTN was studied in 629 patients with intracerebral hemorrhage presenting within 48 hours and with systolic blood pressure 140 mm Hg. The primary outcome was the modified Rankin Scale at 90 days. Results Mean blood pressure at baseline was 172/93 mm Hg and significantly lower (difference -7.5/-4.2 mm Hg; both P0.05) on day 1 in 310 patients allocated to GTN when compared with 319 randomized to no GTN. No difference in the modified Rankin Scale was observed between those receiving GTN versus no GTN (adjusted odds ratio for worse outcome with GTN, 1.04; 95% confidence interval, 0.78-1.37; P=0.84). In the subgroup of 61 patients randomized within 6 hours, GTN improved functional outcome with a shift in the modified Rankin Scale (odds ratio, 0.22; 95% confidence interval, 0.07-0.69; P=0.001). There was no significant difference in the rates of serious adverse events between GTN and no GTN. Conclusions In patients with intracerebral hemorrhage within 48 hours of onset, GTN lowered blood pressure was safe but did not improve functional outcome. Very early treatment might be beneficial but needs assessment in further studies.en_US
dc.description.sponsorshipBupa UK Foundation; Medical Research CouncilMedical Research Council UK (MRC) [G0501797]; Agency for Science, Technology and Research (Singapore)Agency for Science Technology & Research (ASTAR); Hypertension Trust (United Kingdom); Queen Elizabeth II Health Sciences Centre Research Fund (Canada); Reichstadt family (United Kingdom); Medical Research CouncilMedical Research Council UK (MRC) [MR/K026992/1]; National Institute for Health ResearchNational Institute for Health Research (NIHR) [NF-SI-0611-10003]en_US
dc.description.sponsorshipEfficacy of Nitric Oxide in Stroke (ENOS) was funded by the Bupa UK Foundation and Medical Research Council (G0501797). Other funders, who supported the trial, were the Agency for Science, Technology and Research (Singapore), Hypertension Trust (United Kingdom), Queen Elizabeth II Health Sciences Centre Research Fund (Canada), and Reichstadt family (United Kingdom).en_US
dc.identifier.doi10.1161/STROKEAHA.115.010368en_US
dc.identifier.endpage52en_US
dc.identifier.issn0039-2499en_US
dc.identifier.issn1524-4628en_US
dc.identifier.issue1en_US
dc.identifier.pmid26645254en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage44en_US
dc.identifier.urihttps://dx.doi.org/10.1161/STROKEAHA.115.010368
dc.identifier.urihttps://hdl.handle.net/20.500.12395/33647
dc.identifier.volume47en_US
dc.identifier.wosWOS:000367136500008en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen_US
dc.relation.ispartofSTROKEen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectblood pressureen_US
dc.subjectcerebral hemorrhageen_US
dc.subjectnitroglycerinen_US
dc.subjectrandomized controlled trialen_US
dc.subjectstrokeen_US
dc.titleGlyceryl Trinitrate for Acute Intracerebral Hemorrhage Results From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial, a Subgroup Analysisen_US
dc.typeArticleen_US

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