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| 1 | It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis显示文摘Background There is concern that blood pressure(BP)lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis.We assessed the effect of glyceryl trinitrate(GTN)in patients with carotid stenosis using data from the Efficacy of Nitric Oxide in Stroke(ENOS)Trial.Methods ENOS randomised 4011 patients with acute stroke and raised systolic BP(140-220 mm Hg)to transdermal GTN or no GTN within 48 hours of onset.Those on prestroke antihypertensives were also randomised to stop or continue their medication for 7 days.The primary outcome was the modified Rankin Scale(mRS)at day 90.Ipsilateral carotid stenosis was split:<30%;30-<50%;50-<70%;≥70%.Data are ORs with 95%CIs adjusted for baseline prognostic factors.results 2023(60.5%)ischaemic stroke participants had carotid imaging.As compared with<30%,≥70%ipsilateral stenosis was associated with an unfavourable shift in mRS(worse outcome)at 90 days(OR 1.88,95%CI 1.44 to 2.44,p<0.001).Those with≥70%stenosis who received GTN versus no GTN had a favourable shift in mRS(OR 0.56,95%CI 0.34 to 0.93,p=0.024).In those with 50-<70%stenosis,continuing versus stopping prestroke antihypertensives was associated with worse disability,mood,quality of life and cognition at 90 days.Clinical outcomes did not differ across bilateral stenosis groups.Conclusions Following ischaemic stroke,severe ipsilateral carotid stenosis is associated with worse functional outcome at 90 days.GTN appears safe in ipsilateral or bilateral carotid stenosis,and might improve outcome in severe ipsilateral carotid stenosis. | Jason P Appleton Lisa J Woodhouse Andrew Belcher Daniel Bereczki Eivind Berge Valeria Caso Hui Meng Chang Hanne K Christensen Ronan Collins John Gommans Ann C Laska George Ntaios Serefnur Ozturk Gillian M Sare Szabolcs Szatmari Yongjun Wang Joanna M Wardlaw Nikola Sprigg Philip M Bath for the ENOS investigators | 2019 | Stroke & Vascular Neurology2019，4，1： | 6 |
| 2 | 显示文摘 | APPLETON J M H TYSON J F MOUNCE R P | 1986 | Anal Chim Acta1986，179，： | 1 |
| 3 | Uncalcified ureteral stent in situ for 13 years 显示文摘 | Wood S J Tansley P D T Appleton D S | 1997 | J Urol1997，157，： | 1 |
| 4 | The Gender Wage Gap in Three African Countries显示文摘 | APPLETON S HODDINOOT J KRISHNAN P | 1999 | Economic Development and Cultural Change1999，47，2： | 1 |
| 5 | Kinetics and yields for the formation of coloured and aromatie thermal degradation products of annatto in foods显示文摘 | Michae J Scotter Laurence Castle Graeme P Appleton | 2001 | Food Chemistry2001，74，： | 1 |
| 6 | Guidelines forcounselling in infertility:outline version显示文摘 | Boivin J Appleton T C Baetens P | | 0，，06： | 1 |
| 7 | The rapid deter- ruination of chemical oxygen demand in waste waters and effluents by flow injection analysis 显示文摘 | Appleton J M H Tyson J F Moouce R P | 1986 | Anal Chim Acta1986，179，： | 1 |
| 8 | The rapid determination of chemical oxygen demand in waste waters and effluents by flow injection analysis 显示文摘 | Appleton J M H Tyson J F and Moouce R P | 1986 | Anal Chim Acta1986，179，： | 1 |
| 9 | The gender wage gap in three African countries 显示文摘 | APPLETON S HODDINOTT J KRISHNAN P | 1999 | Economic Development and Cultural Change1999，47，2： | 1 |
| 10 | Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women显示文摘 | Teresa S.M Tsang Bernard J Gersh Christopher P Appleton A.Jamil Tajik Marion E Barnes Kent R Bailey Jae K Oh Cynthia Leibson Samantha C Montgomery James B Seward | 2002 | Journal of the American College of Cardiology2002，，： | 1 |
| 11 | Left atrial size: physiologic determinants and clinical appli- cations显示文摘 | ABHAYARATNA W P SEWARD J B APPLETON C P | 2006 | Journal of the American College of Cardiology2006，47，12： | 1 |
| 12 | Ventricular Taehycardia in the Absence of Structural Heart Dis- ease显示文摘 | Komandoor Srivathsan Steven J I_ester Christopher P Appleton | 2005 | Indian Pacing Electrophysiol J2005，5，2： | 1 |
| 13 | The role of left atrial function in diatolic heart failure显示文摘 | APPLETON C P KOVA S J | 2009 | Circ Cardiovac Imaging2009，2，1： | 1 |
| 14 | Uncalcified ureteral stent in situ for 13 years显示文摘 | Wood S J Tansley P D Appleton D S | 1997 | J Urol1997，157，3： | 1 |
| 15 | Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonval- vularatrial fibrillation in 840 elderly men and women 显示文摘 | Tsang T S Gersh B J Appleton C P | 2002 | Am Coil Cardiol2002，40，2： | 1 |
| 16 | The gender wage gap in three African countries 显示文摘 | APPLETON S J HODDINOTF P KRISHNAN | 1999 | Economic Development and Cultural Change1999，47，2： | 1 |
| 17 | Gene discovery in the adenophorean nematode Trichinella spiralis : an analysis of transcription from three life cycle stages显示文摘 | MITREVA M J ASMER D P APPLETON J | 2004 | Mol Biochem Parasitol2004，137，2： | 1 |
| 18 | The role of left atrial function indiastolic heart failure显示文摘 | APPLETON C P KOVACS S J | 2009 | Circ Cardiovasc Imaging2009，2，1： | 1 |
| 19 | Left atrial size:physiologic determinants and clinical applications显示文摘 | ABHAYARATNA W P SEWARD J B APPLETON C P | 2006 | J Am Coll Cardiol2006，47，： | 1 |
| 20 | Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women显示文摘 | TSANG T S GERSH B J APPLETON C P | 2002 | J Am Coil Cardiol2002，40，9： | 1 |
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