Giving transdermal nitroglycerin to stroke patients in the ambulance within 3 hours of symptom onset was not shown to be of any benefit in the MR ASAP trial.
The trial involved both patients with ischemic stroke and those with hemorrhagic stroke. In contrast to a previous randomized trial, RIGHT-2, there was no sign of harm with nitroglycerin at 90 days among patients with intracerebral hemorrhage (ICH) in MR ASAP despite a trend toward higher mortality duirng the first 7 days in this group.
The trial was presented on September 1 at the virtual European Stroke Organisation Conference (ESOC) 2021 by Simone Uniken Venema, a PhD candidate at Utrecht University, Utrecht, the Netherlands.
Summing up the clinical implications of the results at an ESOC press conference, senior study investigator Bart van der Worp, Utrecht University Medical Center, said: "I think nitroglycerin in the very early hours after stroke onset in the prehospital setting is now dead because of these results and those from the RIGHT-2 results where there was a trend towards harm in patients with ICH.
"I do think, however, that nitroglycerin could be tested at a later point in time, and I think a trial on this is being planned," van de Worp added.
