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The RIGHT Trial: Rapid Intervention with Glyceryl trinitrate (GTN) in Hypertensive stroke Trial
ISRCTN ISRCTN66434824
ClinicalTrials.gov identifier
Public title The RIGHT Trial: Rapid Intervention with Glyceryl trinitrate (GTN) in Hypertensive stroke Trial
Scientific title Determining the potential of ambulance-based randomised controlled trials in patients with hyperacute stroke: assessment of glyceryl trinitrate in lowering blood pressure
Acronym RIGHT
Serial number at source N/A
Study hypothesis 1. To assess the feasibility of performing an ambulance-based trial in patients with hyperacute stroke, a key question for the future testing of potential interventions aimed at neuroprotection and physiological control
2. To assess the effect of glyceryl trinitrate (GTN) on blood pressure (BP) in this setting
Ethics approval Ethics approval pending from the Nottingham Research Ethics Committee 2 as of 18/02/08 (ref: 08/H0408/18).
Study design Ambulance-based, single city, single-blind, randomised controlled trial with blinded outcome assessment.
Countries of recruitment United Kingdom
Disease/condition/study domain Acute stroke
Participants - inclusion criteria 1. Adult patients of either sex; greater than 40 years of age
2. Paramedic assessment of stroke on basis of positive ‘Face & Arm weakness and Speech abnormality Test (FAST) in the context of a call to a patient with a ‘possible acute stroke’
3. Event less than 4 hours of onset (sleep stroke - onset as bed time)
4. High systolic BP (greater than 140 mmHg)
Participants - exclusion criteria 1. No consent/assent is available
2. GTN is indicated (e.g. concurrent angina)
3. GTN is contraindicated (e.g. dehydration, hypovolaemia)
4. Aged less than 40 years
5. Coma; Glasgow Coma Scale (GCS) score less than or equal to 8
6. History of seizures
7. Non-ambulatory pre-morbidly (modified Rankin scale of greater than 2)
8. Hypoglycaemia (if glucose tested)
9. Patients from a nursing home
Anticipated start date 01/03/2008
Anticipated end date 31/12/2009
Status of trial Completed
Patient information material Not available in web format, please use the contact details below to request a patient information sheet.
Target number of participants 80
Interventions Transdermal GTN (5 mg) or no patch.

Total duration of treatment: 7 days
Total duration of follow up: 90 days
Primary outcome measure(s) To assess the feasibility of using the ambulance service to test and deliver treatment for stroke in the hyperacute setting, will be measured as effects of GTN on blood pressure at 2 hours post-treatment.
Secondary outcome measure(s) To assess the effects of GTN on:
1. Blood pressure
2. Pulse pressure (PP)
3. Rate pressure product (RPP)
4. Surrogate markers of efficacy in blood in the hyperacute setting

Measured in hospital, day 7/discharge/death, and day 90.
Sources of funding No funding as of 19/02/08
Trial website
Publications
Contact name Prof  Philip   Bath
  Address Division of Stroke Medicine
University of Nottingham
Clinical Sciences Building
City Hospital
Hucknall Road
  City/town Nottingham
  Zip/Postcode NG5 1PB
  Country United Kingdom
  Tel +44 (0)115 823 1765
  Fax +44 (0)115 823 1767
  Email philip.bath@nottingham.ac.uk
Sponsor University of Nottingham (UK)
  Address c/o Mr Paul Cartledge
Head of Research Grants and Research Innovation Services
King’s Meadow Campus
Lenton Lane
  City/town Nottingham
  Zip/Postcode NG7 2NR
  Country United Kingdom
  Tel +44 (0)115 951 5670
  Email Paul.cartledge@nottingham.ac.uk
  Sponsor website: http://www.nottingham.ac.uk/
Date applied 18/02/2008
Last edited 09/05/2008
Date ISRCTN assigned 09/05/2008
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