Effect of Routine Low-Dose Oxygen Supplementation on Death and Disability in Adults With Acute Stroke: The Stroke Oxygen Study Randomized Clinical Trial.

Sim, J; Bishop, J; Gray, R; and the Stroke Oxygen Study Collaborative Group, Stroke Oxygen Study Investigators; Roffe, C; Nevatte, T; Ives, N; Ferdinand, P

doi:10.1001/jama.2017.11463

Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease (2023)
Journal Article
Wardlaw, J. M., Woodhouse, L. J., Mhlanga, I. I., Oatey, K., Heye, A. K., Bamford, J., …Elyas, S. (2023). Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease. JAMA Neurology, 80(7), 682. https://doi.org/10.1001/jamaneurol.2023.1526

ImportanceCerebral small vessel disease (cSVD) is a common cause of stroke (lacunar stroke), is the most common cause of vascular cognitive impairment, and impairs mobility and mood but has no specific treatment.ObjectiveTo test the feasibility, drug... Read More about Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease.

Reperfusion by endovascular thrombectomy and early cerebral edema in anterior circulation stroke: Results from the SITS-International Stroke Thrombectomy Registry (2023)
Journal Article
Thorén, M., Escudero-Martínez, I., Andersson, T., Chen, S., Tsao, N., Khurana, D., …Ahmed, N. (2023). Reperfusion by endovascular thrombectomy and early cerebral edema in anterior circulation stroke: Results from the SITS-International Stroke Thrombectomy Registry. International Journal of Stroke, 18(10), 1193-1201. https://doi.org/10.1177/17474930231180451

Background: A large infarct and expanding cerebral edema (CED) due to a middle cerebral artery occlusion confers a 70% mortality unless treated surgically. There is still conflicting evidence whether reperfusion is associated with a lower risk for C... Read More about Reperfusion by endovascular thrombectomy and early cerebral edema in anterior circulation stroke: Results from the SITS-International Stroke Thrombectomy Registry.

World Federation for Interventional Stroke Treatment (WIST) multispecialty training guidelines for endovascular stroke intervention (2023)
Journal Article
Roffe. (2023). World Federation for Interventional Stroke Treatment (WIST) multispecialty training guidelines for endovascular stroke intervention. Postępy w Kardiologii Interwencyjnej, 19(1), 6-13. https://doi.org/10.5114/aic.2023.124742

Introduction: Today, endovascular treatment (EVT) is the therapy of choice for strokes due to acute large vessel occlusion, irrespective of prior thrombolysis. This necessitates fast, coordinated multi-specialty collaboration. Currently, in most cou... Read More about World Federation for Interventional Stroke Treatment (WIST) multispecialty training guidelines for endovascular stroke intervention.

Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial (2022)
Journal Article
Roffe. (2022). Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial. BMC Emergency Medicine, https://doi.org/10.1186/s12873-021-00560-x

Background: Prehospital stroke trials will inevitably recruit patients with non-stroke conditions, so called stroke mimics. We undertook a pre-specified analysis to determine outcomes in patients with mimics in the second Rapid Intervention with Glyc... Read More about Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial.

Systematic voiding programme in adults with urinary incontinence following acute stroke: the ICONS-II RCT (2022)
Journal Article
Watkins, C., Tishkovskaya, S., Brown, C., Sutton, C., Garcia, Y. S., Forshaw, D., …Panton, C. (2022). Systematic voiding programme in adults with urinary incontinence following acute stroke: the ICONS-II RCT. Health Technology Assessment, 26(31), 1-88. https://doi.org/10.3310/eftv1270

Background Urinary incontinence affects around half of stroke survivors in the acute phase, and it often presents as a new problem after stroke or, if pre-existing, worsens significantly, adding to the disability and helplessness caused by neurologic... Read More about Systematic voiding programme in adults with urinary incontinence following acute stroke: the ICONS-II RCT.

Pre-hospital Transdermal Glyceryl Trinitrate in Patients With Stroke Mimics: Data From the Right-2 Randomised-controlled Ambulance Trial (2022)
Journal Article
Tunnage, B., Woodhouse, L. J., Dixon, M., Anderson, C., Ankolekar, S., Appleton, J., …Investigators, R. (in press). Pre-hospital Transdermal Glyceryl Trinitrate in Patients With Stroke Mimics: Data From the Right-2 Randomised-controlled Ambulance Trial. BMC Emergency Medicine, 22, Article 2. https://doi.org/10.1186/s12873-021-00560-x

Background: Prehospital stroke trials will inevitably recruit patients with non-stroke conditions, so called stroke mimics. We undertook a pre-specified analysis to determine outcomes in patients with mimics in the second Rapid Intervention with Glyc... Read More about Pre-hospital Transdermal Glyceryl Trinitrate in Patients With Stroke Mimics: Data From the Right-2 Randomised-controlled Ambulance Trial.

Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial. (2021)
Journal Article
Roffe. (2021). Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial. Stroke, 1141-1148. https://doi.org/10.1161/STROKEAHA.121.035191

BACKGROUND: Seeking consent rapidly in acute stroke trials is crucial as interventions are time sensitive. We explored the association between consent pathways and time to enrollment in the TICH-2 (Tranexamic Acid in Intracerebral Haemorrhage-2) rand... Read More about Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial..

Use of Pulmonary Computed Tomography for Evaluating Suspected Stroke-Associated Pneumonia (2021)
Journal Article
Roffe. (2021). Use of Pulmonary Computed Tomography for Evaluating Suspected Stroke-Associated Pneumonia. Journal of Stroke and Cerebrovascular Diseases, 1-8. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105757

Objectives Accurate and timely diagnosis of pneumonia complicating stroke remains challenging and the diagnostic accuracy of chest X-ray (CXR) in the setting of stroke-associated pneumonia (SAP) is uncertain. The overall objective of this study was t... Read More about Use of Pulmonary Computed Tomography for Evaluating Suspected Stroke-Associated Pneumonia.

Purines for Rapid Identification of Stroke Mimics (PRISM): study protocol for a diagnostic accuracy study (2021)
Journal Article
Roffe. (2021). Purines for Rapid Identification of Stroke Mimics (PRISM): study protocol for a diagnostic accuracy study. Diagnostic and Prognostic Research, https://doi.org/10.1186/s41512-021-00098-3

Abstract Background Rapid treatment of stroke improves outcomes, but accurate early recognition can be challenging. Between 20 and 40% of patients suspected to have stroke by ambulance and emergency department staff later receive a non-stroke ‘mimic’... Read More about Purines for Rapid Identification of Stroke Mimics (PRISM): study protocol for a diagnostic accuracy study.

The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK (2021)
Journal Article
Sanyal, R., Raseta, M., Natarajan, I., & Roffe, C. (2022). The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK. International Journal of Stroke, 17(1), 59-66. https://doi.org/10.1177/1747493021995590

Background Functional neurological disorder is defined by symptoms not explained by the current model of disease and its pathophysiology. It is found in 8.4% of patients presenting as acute stroke. Treatment is difficult and recurrence rates are high... Read More about The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK.

Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome, and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage (2020)
Journal Article
Roffe. (2020). Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome, and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage. Stroke, 121-128. https://doi.org/10.1161/STROKEAHA.119.026128

Background and Purpose— Blend, black hole, island signs, and hypodensities are reported to predict hematoma expansion in acute intracerebral hemorrhage. We explored the value of these noncontrast computed tomography signs in predicting hematoma expan... Read More about Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome, and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage.

Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage (2019)
Journal Article
Roffe. (2019). Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage. Stroke, 3064 -3071. https://doi.org/10.1161/STROKEAHA.119.026389

Background and Purpose Pilot trials suggest that glyceryl trinitrate (GTN; nitroglycerin) may improve outcome when administered early after stroke onset. Methods We undertook a multicentre, paramedic-delivered, ambulance-based, prospective rando... Read More about Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage.

Association of Baseline Hyperglycaemia with Outcomes of Diabetic and Non-diabetic Acute Ischaemic Stroke Patients treated with Intravenous Thrombolysis: A Propensity Score Matched Analysis from the SITS-ISTR Registry (2019)
Journal Article
Roffe. (2019). Association of Baseline Hyperglycaemia with Outcomes of Diabetic and Non-diabetic Acute Ischaemic Stroke Patients treated with Intravenous Thrombolysis: A Propensity Score Matched Analysis from the SITS-ISTR Registry. Diabetes, db190440 - db190440. https://doi.org/10.2337/db19-0440

Available data from observational studies on the association of admission hyperglycaemia (aHG) with outcomes of acute ischaemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) are contradictory especially when stratified by diabetes... Read More about Association of Baseline Hyperglycaemia with Outcomes of Diabetic and Non-diabetic Acute Ischaemic Stroke Patients treated with Intravenous Thrombolysis: A Propensity Score Matched Analysis from the SITS-ISTR Registry.

Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT. (2019)
Journal Article
Roffe. (2019). Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT. Health Technology Assessment, 1 - 48. https://doi.org/10.3310/hta23350

BACKGROUND:Tranexamic acid reduces death due to bleeding after trauma and postpartum haemorrhage. OBJECTIVE:The aim of the study was to assess if tranexamic acid is safe, reduces haematoma expansion and improves outcomes in adults with spontaneous in... Read More about Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT..

The association between early neurological deterioration and whole blood purine concentration during acute stroke (2019)
Journal Article
Roffe. (2019). The association between early neurological deterioration and whole blood purine concentration during acute stroke. Biomarker Research, https://doi.org/10.1186/s40364-019-0158-y

Background Early neurological deterioration (END) is common after stroke. Prediction could identify patients requiring additional monitoring and intervention. Purines, breakdown products of adenosine triphosphate which accumulate during acute hypoxi... Read More about The association between early neurological deterioration and whole blood purine concentration during acute stroke.

Point-of-care measurements reveal release of purines into venous blood of stroke patients (2019)
Journal Article
Roffe. (2019). Point-of-care measurements reveal release of purines into venous blood of stroke patients. Purinergic Signalling, 237-246. https://doi.org/10.1007/s11302-019-09647-4

Stroke is a leading cause of death and disability. Here, we examine whether point-of-care measurement of the purines, adenosine, inosine and hypoxanthine, which are downstream metabolites of ATP, has potential to assist the diagnosis of stroke. In a... Read More about Point-of-care measurements reveal release of purines into venous blood of stroke patients.

Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial (2018)
Journal Article
Roffe. (2018). Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet, 2107-2115. https://doi.org/10.1016/S0140-6736%2818%2931033-X

Background Tranexamic acid can prevent death due to bleeding after trauma and post-partum haemorrhage. We aimed to assess whether tranexamic acid reduces haematoma expansion and improves outcome in adults with stroke due to intracerebral haemorrhage... Read More about Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial.

Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial. (2018)
Journal Article
Roffe. (2018). Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial. Translational Stroke Research, 120 -129. https://doi.org/10.1007/s12975-017-0548-0

Post-stroke dysphagia is common, associated with poor outcome and often requires non-oral feeding/fluids. The relationship between route of feeding and outcome, as well as treatment with glyceryl trinitrate (GTN), was studied prospectively. The Effic... Read More about Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial..

Routine low-dose continuous or nocturnal oxygen for people with acute stroke: three-arm Stroke Oxygen Supplementation RCT. (2018)
Journal Article
Bishop, J., Sim, J., Penaloza, C., Jowett, S., Gray, R., Ferdinand, P., …Roffe, C. (2018). Routine low-dose continuous or nocturnal oxygen for people with acute stroke: three-arm Stroke Oxygen Supplementation RCT. Health Technology Assessment, 22(14), 1 - 88. https://doi.org/10.3310/hta22140

BACKGROUND: Stroke is a major cause of death and disability worldwide. Hypoxia is common after stroke and is associated with worse outcomes. Oxygen supplementation could prevent hypoxia and secondary brain damage. OBJECTIVES: (1) To assess whether or... Read More about Routine low-dose continuous or nocturnal oxygen for people with acute stroke: three-arm Stroke Oxygen Supplementation RCT..

Effect of Routine Low-Dose Oxygen Supplementation on Death and Disability in Adults With Acute Stroke: The Stroke Oxygen Study Randomized Clinical Trial. (2017)
Journal Article
Sim, J., Bishop, J., Gray, R., and the Stroke Oxygen Study Collaborative Group, S. O. S. I., Roffe, C., Nevatte, T., …Ferdinand, P. (2017). Effect of Routine Low-Dose Oxygen Supplementation on Death and Disability in Adults With Acute Stroke: The Stroke Oxygen Study Randomized Clinical Trial. Journal of the American Medical Association, 318(12), 1125 - 1135. https://doi.org/10.1001/jama.2017.11463

Importance: Hypoxia is common in the first few days after acute stroke, is frequently intermittent, and is often undetected. Oxygen supplementation could prevent hypoxia and secondary neurological deterioration and thus has the potential to improve r... Read More about Effect of Routine Low-Dose Oxygen Supplementation on Death and Disability in Adults With Acute Stroke: The Stroke Oxygen Study Randomized Clinical Trial..

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