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
Table 2
Outcomes by time from stroke onset to randomisation. Data are number (%), mean difference, or odds ratio with 95% confidence intervals. Comparisons by binary logistic regression, ordinal logistic regression, or linear regression, with adjustment for trial. Results in bold are statistically significant, .
OTR (hours)
All
≤6
6.1–12
12.1–24
24.1–48
>48
Patients ()
4197
312 (7.43)
440 (10.48)
1069 (25.47)
2260 (53.85)
113 (2.69)
After first patch
SBP (mmHg)
−7.4 (−8.8, −6.0)
−9.4 (−14.3, −4.5)
−8.3 (−12.7, −3.9)
−5.3 (−8.1, −2.5)
−7.5 (−9.4, −5.6)
−12.3 (−21.0, −3.7)
DBP (mmHg)
−3.3 (−4.2, −2.5)
−2.4 (−5.7, 0.9)
−4.5 (−7.4, −1.7)
−3.3 (−5.0, −1.6)
−3.3 (−4.6, −2.1)
−0.9 (−5.9, 4.1)
HR (bpm)
1.9 (1.0, 2.8)
1.9 (−1.7, 5.6)
−0.1 (−3.1, 3.1)
1.7 (−0.1, 3.5)
2.1 (0.9, 3.4)
4.8 (0.1, 9.5)
Treatment end
Patients (%)
4188 (99.8)
309 (99.0)
440 (100)
1067 (99.8)
2256 (99.8)
113 (100)
Death
1.15 (0.79, 1.68)
0.94 (0.23, 3.81)
1.52 (0.42, 5.48)
0.89 (0.47, 1.69)
1.37 (0.77, 2.42)
1.00 (0, ∞)
Deterioration
1.29 (1.00, 1.66)
0.58 (0.28, 1.23)
1.94 (0.84, 4.48)
1.22 (0.76, 1.97)
1.45 (1.00, 2.10)
0.86 (0.06, 12.67)
Recurrence
1.39 (0.88, 2.18)
0.46 (0.14, 1.54)
2.15 (0.65, 7.17)
2.24 (0.95, 5.28)
1.04 (0.48, 2.26)
1.77 (0, ∞)
SSS/58
0.33 (−0.26, 0.91)
2.33 (−0.42, 5.09)
−0.19 (−2.20, 1.81)
0.01 (−1.18, 1.20)
0.14 (−0.59, 0.87)
0.84 (−2.08, 3.76)
Headache
2.42 (1.99, 2.95)
2.16 (1.04, 4.48)
2.37 (1.29, 4.36)
2.55 (1.76, 3.69)
2.41 (1.84, 3.16)
NC
Hypotension
3.66 (2.06, 6.51)
2.67 (0.65, 11.01)
9.64 (1.11, 83.62)
14.85 (1.95, 113.18)
2.60 (1.24, 5.45)
NC
Hypertension
0.87 (0.68, 1.10)
0.71 (0.32, 1.60)
1.88 (0.89, 3.98)
0.92 (0.56, 1.50)
0.74 (0.53, 1.04)
0 (0, ∞)
SAEs
1.07 (0.88, 1.29)
0.81 (0.42, 1.55)
2.04 (1.14, 3.62)
1.04 (0.74, 1.48)
0.98 (0.74, 1.28)
NC
End-of-hospital
Patients (%)
4173 (99.4)
307 (98.4)
439 (99.7)
1066 (99.7)
2245 (99.3)
113 (100)
Death
1.04 (0.81, 1.32)
0.45 (0.17, 1.18)
1.82 (0.86, 3.81)
1.19 (0.74, 1.91)
0.97 (0.69, 1.37)
0 (0, 0)
Death/institution
0.91 (0.79, 1.04)
0.79 (0.47, 1.33)
1.14 (0.73, 1.77)
0.95 (0.72, 1.25)
0.91 (0.75, 1.10)
0.60 (0.17, 2.14)
LoS (days)
0.07 (−1.3, 1.44)
0.02 (−4.59, 4.63)
−2.54 (−5.87, 0.78)
−0.48 (−3.14, 2.17)
1.16 (−0.73, 3.05)
−1.97 (−20.97, 17.04)
Day 90
Patients (%)
4197 (100)
312 (100)
440 (100)
1069 (100)
2260 (100)
113 (100)
Death
0.87 (0.71, 1.07)
0.32 (0.14, 0.78)
1.20 (0.68, 2.11)
1.00 (0.67, 1.50)
0.86 (0.64, 1.14)
0 (0, 0)
mRS
0.99 (0.89, 1.10)
0.52 (0.34, 0.78)
1.06 (0.76, 1.49)
1.08 (0.87, 1.33)
1.04 (0.90, 1.21)
0.63 (0.25, 1.58)
BI
1.73 (−0.08, 3.55)
9.64 (3.19, 16.09)
0.27 (−5.92, 6.46)
0.03 (−3.57, 3.64)
1.31 (−1.11, 3.72)
3.09 (−6.69, 12.87)
tMMSE
0.34 (−0.16, 0.84)
2.09 (0.65, 3.54)
−0.25 (−1.83, 1.33)
−0.18 (−1.10, 0.75)
0.41 (−0.30, 1.11)
−4.49 (−7.37, −1.61))
TICS
0.16 (−0.55, 0.88)
3.56 (1.20, 5.91)
0.09 (−2.16, 2.34)
−0.79 (−2.12, 0.54)
0.19 (−0.80, 1.18)
−9.63 (−12.51, −6.74)
Animal naming
−0.06 (−0.60, 0.47)
1.63 (−0.13, 3.39)
−0.02 (−1.71, 1.67)
−0.12 (−1.15, 0.90)
−0.25 (−0.98, 0.48)
−4.68 (−7.3, −2.05)
ZDS
−0.38 (−1.80, 1.04)
−8.34 (−13.32, −3.36)
0.59 (−3.99, 5.16)
1.63 (−1.14, 4.39)
−0.31 (−2.21, 1.58)
4.68 (−11.16, 20.52)
HUS
0 (−0.02, 0.02)
0.05 (−0.02, 0.13)
−0.01 (−0.08, 0.05)
−0.02 (−0.06, 0.02)
0.01 (−0.02, 0.03)
0.06 (−0.1, 0.22)
EQ-VAS
0.69 (−1.06, 2.43)
5.97 (−0.30, 12.24)
−1.16 (−6.91, 4.60)
−0.84 (−4.27, 2.60)
0.55 (−1.79, 2.90)
7.37 (−2.85, 17.59)
Death/institution
0.89 (0.77, 1.03)
0.63 (0.35, 1.11)
1.06 (0.68, 1.67)
0.90 (0.67, 1.21)
0.92 (0.75, 1.12)
0 (0, ∞)
SAEs
1.07 (0.92, 1.25)
0.58 (0.34, 1.01)
1.38 (0.88, 2.17)
1.04 (0.78, 1.39)
1.12 (0.91, 1.38)
0.25 (0, 22.31)
∞ Value tends towards infinity. Values for death: BI −5, animal naming −1, EQ-VAS −1, TICS-M −1, tMMSE −1, HUS 0, mRS 6, and ZDS 102.5. BI: Barthel index; bpm: beats per minute; DBP: diastolic blood pressure; EQ: EuroQol; EQ-VAS: EuroQol Visual Analogue Scale; HR: heart rate; HUS: health utility status (derived from EQ-5D); LoS: length of stay; mRS: modified Rankin scale; NC: not collected; OTR: onset to randomisation; SAE: serious adverse event; SBP: systolic blood pressure; SSS: Scandinavian Stroke Scale; TICS: telephone interview cognition scale; tMMSE: telephone mini-mental state examination; ZDS: Zung depression scale.
