|THE ‘RAPID INTERVENTION WITH GLYCERYL TRINITRATE IN HYPERTENSIVE STROKE TRIAL’ (RIGHT)
|Nottingham University Hospitals Charity
|The primary aim was to assess the feasibility of using ambulance service practitioners to assess and deliver treatments for stroke in the ultra-acute setting after stroke. The secondary aim was to assess the effect of GTN use in ultra-acute stroke on safety, clinical, functional, and haemo-dynamic outcomes.
Comparison of systolic blood pressure at two hours post randomisation between GTN and no GTN groups. This outcome was chosen since it represents the sum of the trial feasibility and intervention, that is, the ability to identify, recruit, randomise, treat with GTN or control, and make measurements in patients with ultra-acute presumed stroke in an ambulance setting, and hand them over to hospital staff. The two hour time reflects the time to peak effect for GTN.
Secondary outcomes explored, comparison between treatment groups including:
Ankolekar, Sandeep and Fuller, Michael and Cross, Ian and Renton, Cheryl and Cox, Patrick and Sprigg, Nikola and Siriwardena, A. Niroshan andBath, Philip M. W. (2013) Feasibility of an ambulance-based stroke trial, and safety of glyceryl trinitrate in ultra-acute stroke: the Rapid Intervention With Glyceryl Trinitrate in Hypertensive Stroke Trial (RIGHT, ISRCTN66434824). Stroke, 44 (11). pp. 3120-3128.
Ankolekar, Sandeep and Parry, Ruth and Sprigg, Nikola and Siriwardena, A. Niroshan and Bath, Philip M. W. (2014) Views of paramedics on their role in an out-of-hospital ambulance-based trial in ultra-acute stroke: qualitative data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial (RIGHT). Annals of Emergency Medicine.
Ankolekar, Sandeep and Sare, Gillian and Geeganage, Chamila and Fuller, Michael and Stokes, Lynn and Sprigg, Nikola and Parry, Ruth andSiriwardena, A. Niroshan and Bath, Philip M. W. (2012) Determining the feasibility of ambulance-based randomised controlled trials in patients with ultra-acute stroke: study protocol for the “Rapid Intervention with GTN in Hypertensive Stroke Trial” (RIGHT, ISRCTN66434824). Stroke Research and Treatment, 2012.
Trial website: http://www.right-trial.org/
|The RIGHT trial, the world’s first completed ambulance-based randomised controlled stroke trial, tested using GTN patches within 4 hours of a stroke by recruiting and treating 41 patients in the ambulance. This has led to funding by the British Heart Foundation of a definitive trial of prehospital GTN patches in ultra-acute stroke.