Abstract 2208: Sex Differences in Ischemic Stroke Mortality

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
James S McKinney ◽  
Yingzi Deng ◽  
Ugo Paolucci ◽  
John B Kostis
Keyword(s):  
Sex Differences ◽  
Ischemic Stroke ◽  
New Jersey ◽  
Cerebral Infarction ◽  
Cox Regression ◽  
Statistical Significance ◽  
Primary Diagnosis ◽  
Stroke Mortality ◽  
Hospital Deaths ◽  
To Receive

Introduction--- Stroke is becoming increasingly more prevalent in women. Prior studies of sex differences in stroke mortality have reported variable findings. Although crude stroke fatality is higher in women, this appears to be mediated by age and other baseline differences. We hypothesized that no differences existed between genders in in-hospital and longer term mortality, as well as in cause of death, after stroke admission. Methods--- We used the Myocardial Infarction Data Acquisition System (MIDAS) database, which includes demographic and clinical data on patients discharged with a primary diagnosis of cerebral infarction from all non-federal acute care hospitals in New Jersey between 1996 and 2007. Out-of-hospital deaths were assessed by matching MIDAS records with New Jersey death registration files. In-hospital, 1-year, and interval (discharge to 1-year) mortality were calculated. Total, cardiovascular disease (CVD), and non-CVD mortality were calculated. Multivariate logistic and Cox regression models were used to measure the effect of sex on in-hospital, 1-year, and interval mortality after adjusting for demographics, comorbidities, hospital type, year of admission, and treatment. Statistical significance was defined as a P -value ≤ 0.01. Results--- 134,441 patients (54.8% female) were admitted with a primary diagnosis of cerebral infarction during the study period. Women were on average 5.1 years older than men. Although the average Charlson Index was lower for women, hypertension, atrial fibrillation, congestive heart failure, dementia, and connective tissue disorders were all more common (p<0.0001). Women were significantly less likely to be treated with intravenous tPA than men (OR = 0.81; 95% CI = 0.73 to 0.89). In-hospital and 1-year mortality rates were 9.3% and 27.2% for women and 8.0% and 22.6% for men. After adjusting for available covariates, women had significantly higher in-hospital (OR = 1.04; 95% CI = 1.01 to 1.09) and 1-year (HR = 1.03; 95% CI = 1.01 to 1.05) mortality than men. Comparisons of in-hospital and interval CVD and non-CVD death rates are presented in the Figure . Conclusion--- Adjusted in-hospital and 1-year mortality was significantly higher for women than men hospitalized for a first ischemic stroke in New Jersey. This excess in morality appears to be driven by significant differences in non-CVD related in-hospital deaths in women. Women were also less likely to receive IV tPA then men after adjusting for available covariates.

Abstract 2206: Trends in Mortality of Acute Ischemic Stroke after Hospital Discharge

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
James S McKinney ◽  
Yingzi Deng ◽  
Ugo Paolucci ◽  
John B Kostis
Keyword(s):  
Ischemic Stroke ◽  
New Jersey ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Hospital Discharge ◽  
Regression Models ◽  
Cox Regression ◽  
Statistical Significance ◽  
Primary Diagnosis ◽  
Cvd Mortality

Introduction--- Advances in emergent treatment and hospital management of acute ischemic stroke (AIS) have decreased in-hospital mortality. Despite this early reduction in mortality, prior research has indicated that up to 25% of patients hospitalized for AIS will be dead one year after admission. We assessed the trends in prognosis for patients hospitalized for AIS. Methods--- We used the Myocardial Infarction Data Acquisition System (MIDAS) database, which includes demographic and clinical data on patients discharged with a primary diagnosis of cerebral infarction from all non-federal acute care hospitals in New Jersey between 1996 and 2007. Out-of-hospital deaths were assessed by matching MIDAS records with New Jersey death registration files. In-hospital, 1-year, and interval (discharge to 1-year) mortality were calculated. Total, cardiovascular disease (CVD), and non-CVD mortality were calculated. Log linear regression models were used for trend analysis. Multivariate logistic and Cox regression models were used to measure the effect of year of admission on in-hospital and 1-year mortality, respectively, after adjusting for demographics, comorbid conditions, and treatment. Statistical significance was defined as a P -value ≤ 0.05. Results--- 134,441 patients were admitted with a primary diagnosis of cerebral infarction during the study period. Significant declines were observed for in-hospital (10.4% to 8.1%, p<0.05) and 1-year (26.0% to 24.0%, p<0.05) mortality. No significant changes were observed in the interval death rate between hospital discharge and 1-year. Significant declines for in-hospital (7.4% to 5.5%, p<0.05) and 1-year (16.9% to 12.8%, p<0.05) CVD mortality were also observed ( Figure , Panel A). Trends in interval CVD showed significant declines after 2003, while interval non-CVD death rates steadily increased ( Figure , Panel B). Multivariate logistic analysis confirmed the declining likelihood of death from CVD versus non-CVD during the study period (OR = 0.954; 95% CI = 0.946 to 0.962). Conclusion--- Stroke patients admitted to New Jersey hospitals had a significant decline in in-hospital and 1-year mortality over the study period. This reduction was primarily driven by reductions in CVD death. Despite this trend no change was observed in interval mortality due to a 25% increase in non-CVD deaths.

scholarly journals Effects of long-term anti-seizure medication monotherapy on all-cause death in patients with post-stroke epilepsy: a nationwide population-based study in Taiwan

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chia-Yu Hsu ◽  
Chun-Yu Cheng ◽  
Jiann-Der Lee ◽  
Meng Lee ◽  
Bruce Ovbiagele
Keyword(s):  
Valproic Acid ◽  
Ischemic Stroke ◽  
Cox Regression ◽  
Population Based ◽  
Primary Diagnosis ◽  
Research Database ◽  
Post Stroke ◽  
Risk Of Death ◽  
Index Stroke

Abstract Objective We aim to compare the effect of long-term anti-seizure medication (ASM) monotherapy on the risk of death and new ischemic stroke in patients with post-stroke epilepsy (PSE). Patients and methods We identified all hospitalized patients (≥ 20 years) with a primary diagnosis of ischemic or hemorrhagic stroke from 2001 to 2012 using the National Health Insurance Research Database in Taiwan. The PSE cohort were defined as the stroke patients (1) who had no epilepsy and no ASMs use before the index stroke, and (2) who had epilepsy and ASMs use after 14 days from the stroke onset. The patients with PSE receiving ASM monotherapy were enrolled and were categorized into phenytoin, valproic acid, carbamazepine, and new ASM groups. We employed the Cox regression model to estimate the unadjusted and adjusted hazard ratios (HRs) with 95 % confidence intervals (CIs) of death and new ischemic stroke within 5 years across all groups, using the new ASM group as the reference. Results Of 6962 patients with PSE using ASM monotherapy, 3917 (56 %) were on phenytoin, 1623 (23 %) on valproic acid, 457 (7 %) on carbamazepine, and 965 (14 %) on new ASMs. After adjusting for confounders, compared with new ASM users, phenytoin users had a higher risk of death in 5 years (HR: 1.64; 95 % CI: 1.06–2.55). On the other hand, all ASM groups showed a similar risk of new ischemic stroke in 5 years. Conclusions Among patients with PSE on first-line monotherapy, compared to new ASMs, use of phenytoin was associated with a higher risk of death in 5 years.

Abstract P320: Dietary Flavonoid Intake and Ischemic Stroke

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Margarethe Goetz ◽  
Viola Vaccarino ◽  
Terry Hartman ◽  
Bill McClellan ◽  
Aaron Anderson ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cox Regression ◽  
Statistical Significance ◽  
Caloric Intake ◽  
Population Based ◽  
Total Flavonoid ◽  
Total Flavonoids ◽  
Inverse Association ◽  
Flavonoid Intake ◽  
Dietary Flavonoid

Introduction: Diets rich in plant-based foods have been associated with lower stroke risk. Plant-based foods contain a variety of potentially cardioprotective compounds, including flavonoids. We assessed the hypothesis that total flavonoid and flavonoid subclass intakes are associated with incident ischemic stroke in a population-based cohort oversampled for non-Hispanic blacks and Stroke Belt residents. Methods: Between 2003 and 2007, REGARDS enrolled black and white Americans age ≥ 45 years. Participants were 20,413 men and women who completed a Block 98 food frequency questionnaire (FFQ) and without stroke at baseline. Total flavonoid and flavonoid subclass (anthocyanidin, flavan-3-ol, flavanone, flavonol, flavone, proanthocyanidin and isoflavone) intakes were estimated using the food consumption reported by the FFQ and the flavonoid contents of each food using USDA databases. Incident strokes were captured by participant report and adjudicated by experts. Quintiles of flavonoid intake were examined as predictors of incident stroke using Cox regression models using the first quintile as the referent. Tests for trend used the quintile medians. Results: Adjusting for age and caloric intake, there was a statistically significant inverse association between total flavonoid intake and ischemic stroke (Q5 v Q1: HR=0.68; 95% CI=0.51, 0.90; p-trend=0.04) however, this association weakened after additional adjustment for demographic, socioeconomic and health behavior factors as well as self-reported CHD at baseline (Q5 v Q1: HR=0.77; 95% CI=0.58, 1.03; p-trend=0.31). A similar pattern was seen for flavanones (age, energy adjusted HR=0.74; 95% CI= 0.57, 0.95; p-trend=0.02; fully adjusted HR= 0.82; 95%CI=0.65, 1.05; p-trend=0.06). Effect estimates for total flavonoids, flavanones, proanthocyanidins, and isoflavones, suggested a protective, though nonlinear association with risk reduction emerging at the second quintile, though these did not achieve statistical significance (total flavonoids, fully adjusted HR (95% CI): Q2= 0.80 (0.61, 1.04); Q3= 0.85 (0.65, 1.11); Q4=0.92 (0.70, 1.19); Q5= 0.77 (0.58, 1.03)). Total flavonoid and flavanone intake were significantly associated with IS in fully adjusted models in women (total: Q5 v Q1 HR=0.62; 95% CI= 0.41, 0.94; p-trend=0.15; flavanones HR=0.65; 95% CI=0.44, 0.95; p-trend=0.03) but not in men (total: Q5 v Q1 HR=0.95; 95% CI= 0.63, 1.42; flavanones HR=0.80; 95% CI=0.58, 1.09; p-interaction=0.67). There was no effect modification by race or region of residence. Conclusion: Total dietary flavonoids and flavanones are associated with a reduction in risk of incident ischemic stroke, particularly in women. The emergence of a protective effect at the second quintile for total flavonoids, flavanones, proanthocyanidins and isoflavones is consistent with previous studies of dietary flavonoid intake and CVD mortality.

scholarly journals Variation in cardiovascular disease care: an Australian cohort study on sex differences in receipt of coronary procedures

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026507 ◽  
Author(s):  
Alexandra Jane Fogg ◽  
Jennifer Welsh ◽  
Emily Banks ◽  
Walter Abhayaratna ◽  
Rosemary J Korda
Keyword(s):  
Sex Differences ◽  
Cohort Study ◽  
Cox Regression ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Primary Diagnosis ◽  
Mortality Data ◽  
Event Analysis ◽  
Crude Rate ◽  
Coronary Procedures

ObjectivesThe aim of this study was to quantify sex differences in diagnostic and revascularisation coronary procedures within 1 year of hospitalisation for acute myocardial infarction (AMI) or angina.DesignThis is a prospective cohort study. Baseline questionnaire (January 2006–April 2009) data from the Sax Institute’s 45 and Up Study were linked to hospitalisation and mortality data (to 30 June 2016) in a time-to-event analysis, treating death as a censoring event.SettingThis was conducted in New South Wales, Australia.ParticipantsThe study included participants aged ≥45 years with no history of ischaemic heart disease (IHD) who were admitted to hospital with a primary diagnosis of AMI (n=4580) or a primary diagnosis of angina or chronic IHD with secondary diagnosis of angina (n=4457).Outcome measuresThe outcome of this study was coronary angiography and coronary revascularisation with percutaneous coronary intervention or coronary artery bypass graft (PCI/CABG) within 1 year of index admission. Cox regression models compared coronary procedure rates in men and women, adjusting sequentially for age, sociodemographic variables and health characteristics.ResultsAmong patients with AMI, 71.6% of men (crude rate 3.45/person-year) and 64.7% of women (2.62/person-year) received angiography; 57.8% of men (1.73/person-year) and 37.4% of women (0.77/person-year) received PCI/CABG. Adjusted HRs for men versus women were 1.00 (0.92–1.08) for angiography and 1.51 (1.38–1.67) for PCI/CABG. In the angina group, 67.3% of men (crude rate 2.36/person-year) and 54.9% of women (1.32/person-year) received angiography; 44.6% of men (0.90/person-year) and 19.5% of women (0.26/person-year) received PCI/CABG. Adjusted HRs were 1.24 (1.14–1.34) and 2.44 (2.16–2.75), respectively.ConclusionsMen are more likely than women to receive coronary procedures, particularly revascularisation. This difference is most evident among people with angina, where clinical guidelines are less prescriptive than for AMI.

Abstract 21: Sex Differences in Post-Stroke Depression in the Elderly

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Naomi Mayman ◽  
Stanley Tuhrim ◽  
Nathalie Jette ◽  
Mandip S Dhamoon ◽  
Laura K Stein
Keyword(s):  
Sex Differences ◽  
Ischemic Stroke ◽  
Time Course ◽  
Cox Regression ◽  
Cumulative Risk ◽  
The Elderly ◽  
Stroke Patients ◽  
Post Stroke ◽  
Post Stroke Depression

Introduction: Post-stroke depression (PSD) occurs in approximately one-third of ischemic stroke patients. However, there is conflicting evidence on sex differences in PSD. Objective: We sought to assess sex differences in risk and time course of PSD in US ischemic stroke (IS) patients. We hypothesized that women are at greater risk of PSD than men, and that a greater proportion of women experience PSD in the acute post-stroke phase. Methods: Retrospective cohort study of 100% de-identified data for US Medicare beneficiaries ≥65 years admitted for ischemic stroke from July 1, 2016 to December 31, 2017. We calculated Kaplan-Meier unadjusted cumulative risk of depression, stratified by sex, up to 1.5 years following index admission. We performed Cox regression to report the hazard ratio (HR) for diagnosis of depression up to 1.5 years post-stroke in males vs. females, adjusting for patient demographics, comorbidities, length of stay, and acute stroke interventions. Results: Female stroke patients (n=90,474) were 20% more likely to develop PSD than males (n=84,427) in adjusted models. Cumulative risk of depression was consistently elevated for females throughout 1.5 years of follow-up (0.2055 [95% CI 0.2013-0.2097] vs. 0.1690 [95% CI 0.1639-0.1741] (log-rank p<0.0001). HR for PSD in females vs. males remained significant in fully adjusted analysis at 1.20 (95% CI 1.17-1.23, p<0.0001). Conclusions: Over 1.5 years of follow-up, female stroke patients had significantly greater hazard of developing PSD, highlighting the need for long-term depression screening in this population and further investigation of underlying reasons for sex differences.

scholarly journals Decompressive craniectomy versus conservative treatment: limits and possibilities in malignant stroke

2020 ◽  
Vol 78 (6) ◽  
pp. 349-355
Author(s):  
Isaac Holanda Mendes MAIA ◽  
Thaissa Pinto de MELO ◽  
Fabrício Oliveira LIMA ◽  
João José de Freitas CARVALHO ◽  
Francisco José Arruda MONT’ALVERNE ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Decompressive Craniectomy ◽  
Statistical Significance ◽  
Northeastern Brazil ◽  
Malignant Infarction ◽  
To Receive ◽  
Surgical Group

ABSTRACT Background: Malignant infarction of the middle cerebral artery (MCA) occurs in a subgroup of patients with ischemic stroke and early decompressive craniectomy (DC) is one of its treatments. Objective: To investigate the functional outcome of patients with malignant ischemic stroke treated with decompressive craniectomy at a neurological emergency center in Northeastern Brazil. Methods: Prospective cohort study, in which 25 patients were divided into two groups: those undergoing surgical treatment with DC and those who continued to receive standard conservative treatment (CT). Functionality was assessed using the modified Rankin Scale (mRS), at follow-up after six months. Results: A favorable outcome (mRS≤3) was observed in 37.5% of the DC patients and 29.4% of CT patients (p=0.42). Fewer patients who underwent surgical treatment died (25%), compared to those treated conservatively (52.8%); however, with no statistical significance. Nonetheless, the proportion of patients with moderate to severe disability (mRS 4‒5) was higher in the surgical group (37.5%) than in the non-surgical group (17.7%). Conclusion: In absolute values, superiority in the effectiveness of DC over CT was perceived, showing that the reduction in mortality was at the expense of increased disability.

Sex differences in IV thrombolysis treatment for acute ischemic stroke

Neurology ◽  
2020 ◽  
Vol 95 (1) ◽  
pp. e11-e22
Author(s):  
Brent Strong ◽  
Lynda D. Lisabeth ◽  
Mathew Reeves
Keyword(s):  
Sex Differences ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Sex Difference ◽  
Meta Analysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Pooled Data ◽  
Lower Treatment ◽  
Tissue Plasminogen ◽  
To Receive

ObjectiveA prior meta-analysis of reports published between 2000 and 2008 found that women were 30% less likely to receive IV recombinant tissue plasminogen activator (rtPA) treatment for stroke than men; we updated this meta-analysis to determine if this sex difference persisted.MethodsWe identified studies that reported sex-specific IV rtPA treatment rates for acute ischemic stroke published between 2008 and 2018. Eligible studies included representative populations of patients with ischemic stroke from hospital-based, registry-based, or administrative data. Random effects odds ratios (ORs) were generated to quantify sex differences.ResultsTwenty-four eligible studies were identified during this 10-year period. The summary unadjusted OR based on 17 studies with data on all ischemic stroke patients was 0.87 (95% confidence interval [CI], 0.82–0.93), indicating that women had 13% lower odds of receiving IV rtPA treatment than men. However, substantial between-study variability existed. Lower treatment odds in women were also observed in 7 studies that provided data on the subgroup of patients eligible for IV rtPA treatment, although the summary OR of 0.95 (95% CI, 0.88–1.02) was not statistically significant. Examination of time trends across 33 studies published between 2000 and 2018 found evidence that the sex difference had narrowed in more recent years.ConclusionsAlthough there is considerable variability in the findings of individual studies, pooled data from recent studies show that women with acute stroke are less likely to be treated with IV thrombolysis compared with men. However, the size of this difference has narrowed compared to studies published before 2008.

scholarly journals Effects of long-term Antiepileptic Drug Monotherapy on All-cause Death in Patients with Post-Stroke Epilepsy: A Nationwide Population-based Study

2020 ◽  
Author(s):  
Chia-Yu Hsu ◽  
Chun-Yu Cheng ◽  
Jiann-Der Lee ◽  
Meng Lee ◽  
Bruce Ovbiagele
Keyword(s):  
Valproic Acid ◽  
Ischemic Stroke ◽  
Antiepileptic Drug ◽  
Cox Regression ◽  
Population Based ◽  
Primary Diagnosis ◽  
Research Database ◽  
Post Stroke ◽  
Risk Of Death

Abstract Objective We aim to compare the effect of long-term antiepileptic drug (AED) monotherapy on the risk of death and recurrent ischemic stroke in patients with post-stroke epilepsy (PSE). Patients and Methods We identified all hospitalized patients (≥20 years) with a primary diagnosis of ischemic or hemorrhagic stroke from 2001 to 2012 using the National Health Insurance Research Database in Taiwan. The PSE cohorts were defined as the stroke patients (1) who had no epilepsy and no AEDs use before the index stroke, and (2) who had epilepsy and AEDs use after 14 days from the stroke onset. The PSE patients receiving AED monotherapy were enrolled and were categorized into phenytoin, valproic acid, carbamazepine, and new AED groups. We employed the Cox regression model to estimate the unadjusted and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of death and recurrent ischemic stroke within 5 years across all groups, using the new AED group as the reference. Results Of 6962 PSE patients using AED monotherapy, 3917 (56%) were on phenytoin, 1623 (23%) on valproic acid, 457 (7%) on carbamazepine, and 965 (14%) on new AEDs. After adjusting for confounders, compared with new AED users, phenytoin users had a higher risk of death in 5 years (HR: 1.64; 95% CI: 1.06-2.55). On the other hand, all AED groups showed a similar risk of recurrent ischemic stroke. Conclusion Among PSE patients on first-line monotherapy, compared to new AEDs, use of phenytoin was associated with a higher risk of death in 5 years.

scholarly journals Sex differences in treatment strategy and adverse outcomes among patients 75 and older with atrial fibrillation in the MarketScan database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vinita Subramanya ◽  
J’Neka S. Claxton ◽  
Pamela L. Lutsey ◽  
Richard F. MacLehose ◽  
Lin Y. Chen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Sex Differences ◽  
Rate Control ◽  
Treatment Strategy ◽  
Cox Regression ◽  
Rhythm Control ◽  
Adverse Outcomes ◽  
Control Treatment ◽  
To Receive

Abstract Background Women with atrial fibrillation (AF) experience greater symptomatology, worse quality of life, and have a higher risk of stroke as compared to men, but are less likely to receive rhythm control treatment. Whether these differences exist in elderly patients with AF, and whether sex modifies the effectiveness of rhythm versus rate control therapy has not been assessed. Methods We studied 135,850 men and 139,767 women aged ≥ 75 years diagnosed with AF in the MarketScan Medicare database between 2007 and 2015. Anticoagulant use was defined as use of warfarin or a direct oral anticoagulant. Rate control was defined as use of rate control medication or atrioventricular node ablation. Rhythm control was defined by use of anti-arrhythmic medication, catheter ablation or cardioversion. We used multivariable Poisson and Cox regression models to estimate the association of sex with treatment strategy and to determine whether the association of treatment strategy with adverse outcomes (bleeding, heart failure and stroke) differed by sex. Results At the time of AF, women were on average (SD) 83.8 (5.6) years old and men 82.5 (5.2) years, respectively. Compared to men, women were less likely to receive an anticoagulant or rhythm control treatment. Rhythm control (vs. rate) was associated with a greater risk for heart failure with a significantly stronger association in women (HR women = 1.41, 95% CI 1.34–1.49; HR men = 1.21, 95% CI 1.15–1.28, p < 0.0001 for interaction). No sex differences were observed for the association of treatment strategy with the risk of bleeding or stroke. Conclusion Sex differences exist in the treatment of AF among patients aged 75 years and older. Women are less likely to receive an anticoagulant and rhythm control treatment. Women were also at a greater risk of experiencing heart failure as compared to men, when treated with rhythm control strategies for AF. Efforts are needed to enhance use AF therapies among women. Future studies will need to delve into the mechanisms underlying these differences.

scholarly journals Effect of sex differences on prognosis of intravenous thrombolysis: data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China)

2020 ◽  
pp. svn-2020-000351 ◽  
Author(s):  
Hongyu Zhou ◽  
Weiqi Chen ◽  
Yuesong Pan ◽  
Yue Suo ◽  
Xia Meng ◽  
...  
Keyword(s):  
Sex Differences ◽  
Ischemic Stroke ◽  
Ischaemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Statistical Significance ◽  
Intravenous Thrombolysis ◽  
Chinese Patients ◽  
Nihss Score ◽  
Significant Difference

Background and purposePrevious studies have reported conflicting results as to whether women have poorer functional outcome than men after thrombolytic therapy. This study aims to investigate the relationship between sex differences and the prognosis of intravenous thrombolysis in Chinese patients with acute ischaemic stroke.MethodsThe patients enrolled in this study were from the Chinese Acute Ischemic Stroke Thrombolysis Monitoring and Registration study. The primary outcome was poor functional outcome, defined as a 3-month modified Rankin score of 3–6. The safe outcome was symptomatic intracranial haemorrhage (SICH) and mortality within 7 days and 90 days. Multiple Cox regression model was used to correct the potential covariates to evaluate the association between sex disparities and prognosis. Furthermore, the interaction of preonset Rankin scores, baseline National Institute of Health Stroke Scale (NIHSS) scores and Trial of Org 10172 in Acute Stroke Treatment (TOAST) types was statistically analysed.ResultsA total of 1440 patients were recruited, including 541 women and 899 men. The baseline information indicated that women were older at the time of onset (66.2±11.2 years vs 61.0±11.3 years, p<0.001), and more likely to have a history of atrial fibrillation (25.3% vs 11.2%, p<0.001), and had a higher NIHSS score on admission (12.3±6.8 vs 11.6±6.7, p=0.04). According to the prognosis analysis of unsatisfactory functional recovery, there was no significant difference between women and men (45.9% vs 37.1%; adjusted OR 1.01, 95% CI 0.75 to 1.37). As for the safe outcome, the proportion of SICH and mortality in women is relatively high but did not reach statistical significance. There was no significant interaction with sex, age, preonset Rankin score, NIHSS score, TOAST classification and the prognosis of intravenous thrombolysis.ConclusionsFor Chinese patients with ischaemic stroke, although women are older and more severe at the time of onset, the prognosis after intravenous thrombolysis is not significantly different from men.

Sign in / Sign up

Export Citation Format

Share Document