Vol 54, No 3 (2020)
Research paper
Published online: 2020-05-29
Submitted: 2020-02-21
Accepted: 2020-04-14
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Sex-related differences among ischaemic stroke patients treated with intravenous thrombolysis in Poland

Małgorzata Wiszniewska, Waldemar Fryze, Anna Wiśniewska, Michał Karliński, Piotr Sobolewski, Grzegorz Krzykowski, Anna Członkowska
DOI: 10.5603/PJNNS.a2020.0040
·
Pubmed: 32469076
·
Neurol Neurochir Pol 2020;54(3):272-276.

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Vol 54, No 3 (2020)
Research paper
Published online: 2020-05-29
Submitted: 2020-02-21
Accepted: 2020-04-14

Abstract

Aim of study. We investigated sex differences i n i schaemic s troke p atients t reated w ith i ntravenous a lteplase. Clinical rationale for study. We suggest that it is necessary to improve care for women with atrial fibrillation. Our data suggests that closer evaluation of treatment for ischaemic stroke in men and women is needed, preferably in the form of a prospective study. Materials and methods. This was a multicentre analysis of 1,830 ischaemic stroke patients treated with alteplase from 2004 to 2012. Data was prospectively collected in the Safe Implementation of Treatments in Stroke (SITS) registry. The main outcome measures were symptomatic intracerebral haemorrhage (sICH) within 36 hours of treatment, three months of functional independence, and mortality. Results. Women were significantly older (mean age 71.3 vs 66.2 years; p < 0.01), more often suffered from hypertension (78.3% vs 70.1%; p < 0.01) and cardio-embolic strokes (34.7% vs 27.1%; p < 0.01), and presented heavier baseline deficits. There were no differences in sICH, but after three months fewer women were functionally independent (46.5% vs 53.3%; p < 0.01) and women had higher mortality (26.0% vs 19.7%; p < 0.01). Conclusions. Of the ischaemic stroke patients treated with intravenous thrombolysis, women had worse long-term outcomes than men. This discrepancy may be explained by the older age and higher proportion of cardio-embolic strokes with more severe baseline deficits. However, multiple logistic analysis did not show that sex itself had an impact on the greater mortality in women after a stroke, or on the poorer prognosis.

Abstract

Aim of study. We investigated sex differences i n i schaemic s troke p atients t reated w ith i ntravenous a lteplase. Clinical rationale for study. We suggest that it is necessary to improve care for women with atrial fibrillation. Our data suggests that closer evaluation of treatment for ischaemic stroke in men and women is needed, preferably in the form of a prospective study. Materials and methods. This was a multicentre analysis of 1,830 ischaemic stroke patients treated with alteplase from 2004 to 2012. Data was prospectively collected in the Safe Implementation of Treatments in Stroke (SITS) registry. The main outcome measures were symptomatic intracerebral haemorrhage (sICH) within 36 hours of treatment, three months of functional independence, and mortality. Results. Women were significantly older (mean age 71.3 vs 66.2 years; p < 0.01), more often suffered from hypertension (78.3% vs 70.1%; p < 0.01) and cardio-embolic strokes (34.7% vs 27.1%; p < 0.01), and presented heavier baseline deficits. There were no differences in sICH, but after three months fewer women were functionally independent (46.5% vs 53.3%; p < 0.01) and women had higher mortality (26.0% vs 19.7%; p < 0.01). Conclusions. Of the ischaemic stroke patients treated with intravenous thrombolysis, women had worse long-term outcomes than men. This discrepancy may be explained by the older age and higher proportion of cardio-embolic strokes with more severe baseline deficits. However, multiple logistic analysis did not show that sex itself had an impact on the greater mortality in women after a stroke, or on the poorer prognosis.

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Keywords

alteplase, ischaemic stroke, sex differences, risk factors, outcome

About this article
Title

Sex-related differences among ischaemic stroke patients treated with intravenous thrombolysis in Poland

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 54, No 3 (2020)

Pages

272-276

Published online

2020-05-29

DOI

10.5603/PJNNS.a2020.0040

Pubmed

32469076

Bibliographic record

Neurol Neurochir Pol 2020;54(3):272-276.

Keywords

alteplase
ischaemic stroke
sex differences
risk factors
outcome

Authors

Małgorzata Wiszniewska
Waldemar Fryze
Anna Wiśniewska
Michał Karliński
Piotr Sobolewski
Grzegorz Krzykowski
Anna Członkowska

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