Sex Differences in Outcomes of Late-Window Endovascular Stroke Therapy-Reference-Cited by-同舟云学术

Sex Differences in Outcomes of Late-Window Endovascular Stroke Therapy

Published:2024-02 Issue:2 Volume:55 Page:278-287
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Abdalkader Mohamad¹^ORCID,Ning Shen¹,Qureshi Muhammad M.¹²^ORCID,Haussen Diogo C.³^ORCID,Strbian Daniel⁴^ORCID,Nagel Simon⁵⁶^ORCID,Demeestere Jelle⁷⁸^ORCID,Puetz Volker⁹¹⁰^ORCID,Mohammaden Mahmoud H.³^ORCID,Olive Gadea Marta¹¹^ORCID,Winzer Simon⁹¹⁰,Yamagami Hiroshi¹²^ORCID,Tanaka Kanta¹³^ORCID,Marto João Pedro¹^ORCID,Tomppo Liisa⁴^ORCID,Henon Hilde¹⁴^ORCID,Sheth Sunil A.¹⁵^ORCID,Ortega-Gutierrez Santiago¹⁶^ORCID,Martinez-Majander Nicolas⁴^ORCID,Caparros Francois¹⁴^ORCID,Lemmens Robin⁷⁸^ORCID,Dusart Anne¹⁷,Bellante Flavio¹⁷,Zaidi Syed F.¹⁸^ORCID,Siegler James E.¹⁹^ORCID,Nannoni Stefania²⁰^ORCID,Kaesmacher Johannes²¹^ORCID,Dobrocky Tomas²¹^ORCID,Farooqui Mudassir¹⁶^ORCID,Salazar-Marioni Sergio¹⁵^ORCID,Virtanen Pekka²²^ORCID,Vandewalle Lieselotte⁷⁸^ORCID,Wouters Anke⁷⁸^ORCID,Jesser Jessica²³^ORCID,Ventura Rita²⁴^ORCID,Castonguay Alicia C.¹⁸^ORCID,Uchida Kazutaka²⁵^ORCID,Puri Ajit S.²⁶,Masoud Hesham E.²⁷^ORCID,Klein Piers¹^ORCID,Mansoor Zain¹,Bui Jenny¹,Kang Matthew¹^ORCID,Mujanovic Adnan²¹^ORCID,Rizzo Federica¹¹^ORCID,Kokkonen Tatu²²^ORCID,Ramos João Nuno²⁸^ORCID,Strambo Davide²⁹^ORCID,Michel Patrik²⁹^ORCID,Möhlenbruch Markus A.²³,Lin Eugene³⁰^ORCID,Kaiser Daniel P.O.³¹¹⁰^ORCID,Yoshimura Shinichi²⁵^ORCID,Sakai Nobuyuki³²^ORCID,Cordonnier Charlotte¹⁴^ORCID,Ringleb Peter A.⁶^ORCID,Roy Daniel³³^ORCID,Zaidat Osama O.³⁰^ORCID,Fischer Urs³⁴^ORCID,Ribo Marc¹¹^ORCID,Raymond Jean³³^ORCID,Nogueira Raul G.³³⁵^ORCID,Nguyen Thanh N.¹³⁶^ORCID

Affiliation:

1. Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center.

2. Radiation Oncology (M.M.Q.), Boston Medical Center.

3. Departments of Neurology, Grady Memorial Hospital (D.C.H., M.H.M., R.G.N.).

4. Departments of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, Finland.

5. Department of Neurology, Klinikum Ludwigshafen, Germany (S. Nagel).

6. Departments of Neurology (S. Nagel, P.A.R.). Heidelberg University Hospital, Germany.

7. Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.).

8. Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.).

9. Department of Neurology (V.P., S.W.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.

10. Dresden Neurovascular Center, Germany (V.P., S.W., D.P.O.K.).

11. Department of Neurology, Hospital Vall d’Hebron, Spain (M.O.G., F.R., M.R.).

12. Department of Stroke Neurology, NHO Osaka National Hospital, Japan (H.Y.).

13. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (K.T.).

14. Department of Neurology, University of Lille, CHU Lille, Inserm, France (H.H., F.C., C.C.).

15. Department of Neurology, UTHealth McGovern Medical School, Houston (S.A.S., S.S.-M.).

16. Department of Neurology, University of Iowa (S.O.-G., M.F.).

17. Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium (A.D., F.B.).

18. Department of Neurology, University of Toledo, Toledo (S.F.Z., A.C.C.).

19. Department of Neurology, University of Chicago (J.E.S.).

20. Clinical Neurosciences, University of Cambridge, United Kingdom (S. Nannoni).

21. Department of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Switzerland (J.K., T.D., A.M.).

22. Radiology (P.V., T.K.), Helsinki University Hospital, Finland.

23. Radiology (J.J., M.A.M.). Heidelberg University Hospital, Germany.

24. Departments of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Occidental, Portugal.

25. Department of Neurosurgery, Hyogo Medical University, Japan (K.U., S.Y.).

26. Interventional Neuroradiology, University of Massachusetts Memorial Medical Center (A.S.P.).

27. Department of Neurology, State University of New York (H.E.M.).

28. Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Occidental, Portugal.

29. Department of Neurology, Lausanne University Hospital, Switzerland (D. Strambo, P.M.).

30. Neuroscience and Stroke Program, Mercy Health St. Vincent Hospital, Toledo (E.L., O.O.Z.).

31. Institute of Neuroradiology (D.P.O.K.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.

32. Neurovascular Research, Kobe City Medical Center General Hospital, Japan (N.S.).

33. Interventional Neuroradiology, CHU Montreal, Canada (D.R., J.R.).

34. Department of Neurology, University Hospital Basel, Switzerland (U.F.).

35. Department of Neurology, University of Pittsburgh Medical Center (R.G.N.).

36. Neurology (T.N.N.), Boston Medical Center.

Abstract

BACKGROUND: The association between sex and outcome after endovascular thrombectomy of acute ischemic stroke is unclear. The aim of this study was to compare the clinical and safety outcomes between men and women treated with endovascular thrombectomy in the late 6-to-24-hour window period. METHODS: This multicenter, retrospective observational cohort study included consecutive patients who underwent endovascular thrombectomy of anterior circulation stroke in the late window from 66 clinical sites in 10 countries from January 2014 to May 2022. The primary outcome was the 90-day ordinal modified Rankin Scale score. Secondary outcomes included 90-day functional independence (FI), return of Rankin (RoR) to prestroke baseline, FI or RoR, symptomatic intracranial hemorrhage, and mortality. Multivariable and inverse probability of treatment weighting methods were used. We explored the interaction of sex with baseline characteristics on the outcomes ordinal modified Rankin Scale and FI or RoR. RESULTS: Of 1932 patients, 1055 were women and 877 were men. Women were older (77 versus 69 years), had higher rates of atrial fibrillation, hypertension, and greater prestroke disability, but there was no difference in baseline National Institutes of Health Stroke Scale score. Inverse probability of treatment weighting analysis showed no difference between women and men in ordinal modified Rankin Scale (odds ratio, 0.98 [95% CI, 0.79–1.21]), FI or RoR (odds ratio, 0.98 [95% CI, 0.78–1.22]), severe disability or mortality (odds ratio, 0.99 [95% CI, 0.80–1.23]). The multivariable analysis of the above end points was concordant. There were no interactions between baseline characteristics and sex on the outcomes of ordinal modified Rankin Scale and FI or RoR. CONCLUSIONs: In late presenting patients with anterior circulation stroke treated with endovascular thrombectomy in the 6 to 24-hour window, there was no difference in clinical or safety outcomes between men and women.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference42 articles.

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2. Stroke in Women

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4. Sex Differences in Outcome After Endovascular Stroke Therapy for Acute Ischemic Stroke