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Relationship between nitrate headache and outcome in patients with acute stroke: results from the efficacy of nitric oxide in stroke (ENOS) trial

引用

Stroke & Vascular Neurology 2021年第2期6卷 180-186页

作者： lucy beishon Lisa J Woodhouse Daniel Bereczki Hanne K Christensen Ronan Collins John Gommans Christina Kruuse George Ntaios Serefnur Ozturk Stephen Phillips Stuart Pocock Szabolcs Szatmari Joanna Wardlaw Nikola Sprigg Philip M Bath Stroke Trials Unit Division of Clinical NeuroscienceUniversity of NottinghamNottinghamUK Department of Neurology Semmelweis UniversityBudapestHungary Bispebjerg Hospital and University of Copenhagen University of CopenhagenCopenhagenDenmark Department of Geriatric and Stroke Medicine Adelaide and Meath HospitalDublinIreland Department of Medicine Hawke's Bay HospitalCamberleyNew Zealand Department of Neurology Herlev Gentofte HospitalUniversity of CopenhagenCopenhagenDenmark Department of Medicine Larissa University HospitalUniversity of ThessalyVolosGreece Department of Neurology Selcuk University Medical FacultyKonyaTurkey Department of Neurology Queen Elizabeth II Health Sciences CentreHalifaxNova ScotiaCanada Medical Statistics Unit London School of Hygiene&Tropical MedicineLondonUK Department of Neurology George Emil Palade University of MedicinePharmacyScience and Technology of Târgu MureșTargu MuresRomania Centre for Clinical Brain Sciences University of EdinburghEdinburghUK Stroke Nottingham University Hospitals NHS TrustNottinghamUK

Introduction Nitrate-induced headache is common and may signify responsive cerebral *** assessed the relationship between nitrate headache and outcome in patients with acute *** and methods Patients were those randomised to glyceryl trinitrate(GTN)versus no GTN in the efficacy of nitric oxide in stroke *** of headache by end of treatment(day 7),and functional outcome(modified Rankin Scale,primary outcome)at day 90,were *** are adjusted for baseline prognostic factors and give OR and mean difference(MD)with 95%*** In 4011 patients,headache was more common in GTN than control(360,18.0% vs 170,8.5%;p<0.001).Nitrate-related headache was associated with:younger age,female sex,higher diastolic blood pressure,non-total anterior circulation syndrome,milder stroke and absence of dysphasia(p<0.05).Nitrate headache was not associated with improved functional outcome(OR 0.90,95% CI 0.73 to 1.10,p=0.30)or death(day 90)(HR 0.64,95% CI 0.40 to 1.02,p=0.062),but reduced death or deterioration(day 7)(OR 0.45,95% CI 0.25 to 0.82),death in hospital(OR 0.44,95% CI 0.22 to 0.88)and improved activities of daily living(Barthel index,MD 3.7,95% CI 0.3 to 7.1)and cognition(telephone interview cognitive screen,MD 2.0,95% CI 0.7 to 3.3)(day 90).Non-nitrate headache was not associated with death,disability or *** and conclusion Development of a nitrate headache by day 7 after stroke may be associated with improved activities of daily living and cognitive impairment at day 90,which was not seen with non-nitrate headache.

关键词： headache patients nitrate

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