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

• Published in: Neurologia i neurochirurgia polska Vol. 54; no. 3; pp. 272 - 276
• Main Authors: Wiszniewska, Małgorzata, Fryze, Waldemar, Wiśniewska, Anna, Karliński, Michał, Sobolewski, Piotr, Krzykowski, Grzegorz, Członkowska, Anna
• Format: Journal Article
• Language: English
• Published: Poland Wydawnictwo Via Medica 01.01.2020
• Subjects: Aged; Brain Ischemia; Cerebral Hemorrhage; Female; Fibrinolytic Agents; Gender differences; Humans; Male; Mortality; Poland; Prospective Studies; Stroke; Thrombolytic Therapy; Tissue Plasminogen Activator; Treatment Outcome; Women; Poland; ischaemic stroke; risk factors; alteplase; outcome; sex differences
• ISSN: 0028-3843; 1897-4260
• DOI: 10.5603/PJNNS.a2020.0040

We investigated sex differences i n i schaemic s troke p atients t reated w ith i ntravenous a lteplase. 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. 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. 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). 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.