Summary of findings for the main comparison. Glyceryl trinitrate (GTN) compared with no GTN for acute stroke.
| Glyceryl trinitrate (GTN) compared with no GTN for acute stroke | ||||||
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Patient or population: people with acute stroke Settings: pre‐hospital / hospital Intervention: GTN Comparison: no GTN | ||||||
| Outcomes | Anticipated absolute effects (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with no GTN / placebo | Risk with GTN compared with no GTN for acute stroke | |||||
| Death or dependency (mRS>2), end of trial (90 days) | 609 per 1,000 | 601 per 1,000 (573 to 631) |
OR 0.97 (0.86 to 1.10) |
4195 (5 studies) | ⊕⊕⊕⊕ high | |
| Death, end of trial (90 days) | 131 per 1,000 | 115 per 1,000 (90 to 184) | OR 0.78 (0.40 to 1.50) | 4197 (5 studies) | ⊕⊕⊕⊕ high | |
| Quality of life, end of trial (90 days) | The mean quality of life (EQ‐5D3L), end of trial ranged across control groups from 0.25 to 0.9. | The mean quality of life (EQ‐5D3L), end of trial in the intervention group was 0.01 lower (0.17 lower to 0.15 higher) | ‐ | 4088 (4 studies) | ⊕⊕⊕⊕ high | Health utility status derived from European Quality of life‐5 dimensions‐3 levels (EQ‐5D3L). Significant heterogeneity between trials (I2 = 78%). |
| Systolic BP, first treatment measurement (<24 hours after randomisation) | The mean systolic BP, first treatment measurement ranged across control groups from 151.13 to 185.17 mmHg. | The mean systolic BP, first treatment measurement in the intervention group was 7.21 mmHg lower (8.58 lower to 5.85 lower) | ‐ | 4197 (5 studies) | ⊕⊕⊕⊕ high | |
| Diastolic BP, first treatment measurement (<24 hours after randomisation) | The mean diastolic BP, first treatment measurement ranged across control groups from 82.34 to 91.0 mmHg. | The mean diastolic BP, first treatment measurement in the intervention group was 3.31 mmHg lower (4.18 lower to 2.45 lower) | ‐ | 4197 (5 studies) | ⊕⊕⊕⊕ high | |
| Heart rate, first treatment measurement (<24 hours after randomisation) | The mean heart rate, first treatment measurement ranged across control groups from 65.5 to 77.27 beats per minute. | The mean heart rate, first treatment measurement in the intervention group was 2.02 beats per minute higher (1.13 higher to 2.91 higher) | ‐ | 4197 (5 studies) | ⊕⊕⊕⊕ high | Significant heterogeneity between trials (I2 = 61%). |
| Adverse event: Headache, on treatment (7‐12 days) | 84 per 1,000 |
180 per 1,000 (125 to 250) |
OR 2.37 (1.55 to 3.62) | 4186 (5 studies) | ⊕⊕⊕⊕ high | |
| BP: blood pressure; CI: confidence interval; GTN: glyceryl trinitrate; MD: mean difference; OR: odds ratio GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||