Ilaria Casetta 1 , Enrico Fainardi 2 , Giovanni Pracucci 2 , Valentina Saia 3 , Fabrizio Sallustio 4 , Valerio da Ros 5 , Sergio Nappini 6 , Patrizia Nencini 6 , Guido Bigliardi 7 , Sergio Vinci 8 , Francesco Grillo 8 , Sandra Bracco 9 , Rossana Tassi 9 , Mauro Bergui 10 , Paolo Cerrato 11 , Andrea Saletti 12 , Alessandro De Vito 12 , Roberto Gasparotti 13 , Mauro Magoni 14 , Luigi Simonetti 15 , Andrea Zini 16 , Maria Ruggiero 17 , Marco Longoni 17 , Lucio Castellan 18 , Laura Malfatto 18 , Paola Castellini 19 , Mirco Cosottini 20 , Alessio Comai 21 , Enrica Franchini 21 , Emilio Lozupone 22 , Giacomo Della Marca 23 , Edoardo Puglielli 24 , Alfonsina Casalena 24 , Claudio Baracchini 25 , Daniele Savio 26 , Enrica Duc 26 , Giuseppe Ricciardi 27 , Manuel Cappellari 27 , Luigi Chiumarulo 28 , Marco Petruzzellis 28 , Anna Cavallini 29 , Nicola Cavasin 30 , Adriana Critelli 30 , Nicola Burdi 31 , Giovanni Boero 31 , Andrea Giorgianni 32 , Maurizio Versino 33 , Francesco Biraschi 34 , Ettore Nicolini 34 , Simone Comelli 35 , Maurizio Melis 35 , Riccardo Padolecchia 3 , Tiziana Tassinari 3 , Nunzio Paolo Nuzzi 36 , Simona Marcheselli 36 , Simona Sacco 37 , Paolo Invernizzi 38 , Ivan Gallesio 39 , Delfina Ferrandi 39 , Maria Fancello 40 , Maria Valeria Saddi 40 , Monia Russo 41 , Aldo Pischedda 42 , Antonio Baule 42 , Marina Mannino 43 , Francesco Florio 44 , Vincenzo Inchingolo 44 , Maria Elena Flacco 45 , Daniele Romano 46 , Umberto Silvagni 47 , Domenico Inzitari 2 , Salvatore Mangiafico 6 , Danilo Toni 34 Show Affiliations »
Abstract
Background and purpose: We sought to investigate whether there are gender differences in clinical outcome after stroke due to large vessel occlusion (LVO) after mechanical thrombectomy (EVT) in a large population of real-world patients. Methods: From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke due to large vessel occlusion. We compared clinical and safety outcomes in men and women who underwent EVT alone or in combination with intravenous thrombolysis (IVT) in the total population and in a Propensity Score matched set. Results: Among 3422 patients included in the study, 1801 (52.6%) were women. Despite older age at onset (mean 72.4 vs 68.7; p < 0.001), and higher rate of atrial fibrillation (41.7% vs 28.6%; p < 0.001), women had higher probability of 3-month functional independence (adjusted odds ratio-adjOR 1.19; 95% CI 1.02-1.38), of complete recanalization (adjOR 1.25; 95% CI 1.09-1.44) and lower probability of death (adjOR 0.75; 95% CI 0.62-0.90). After propensity-score matching, a well-balanced cohort comprising 1150 men and 1150 women was analyzed, confirming the same results regarding functional outcome (3-month functional independence: OR 1.25; 95% CI 1.04-1.51), and complete recanalization (OR 1.29; 95% CI 1.09-1.53). Conclusions: Subject to the limitations of a non-randomized comparison, women with stroke due to LVO treated with mechanical thrombectomy had a better chance to achieve complete recanalization, and 3-month functional independence than men. The results could be driven by women who underwent combined treatment. © European Stroke Organisation 2022.
Background and purpose: We sought to investigate whether there are gender differences in clinical outcome after stroke due to large vessel occlusion (LVO) after mechanical thrombectomy (EVT) in a large population of real-world patients. Methods: From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke due to large vessel occlusion. We compared clinical and safety outcomes in men and women who underwent EVT alone or in combination with intravenous thrombolysis (IVT) in the total population and in a Propensity Score matched set. Results: Among 3422 patients included in the study, 1801 (52.6%) were women. Despite older age at onset (mean 72.4 vs 68.7; p < 0.001), and higher rate of atrial fibrillation (41.7% vs 28.6%; p < 0.001), women had higher probability of 3-month functional independence (adjusted odds ratio-adjOR 1.19; 95% CI 1.02-1.38), of complete recanalization (adjOR 1.25; 95% CI 1.09-1.44) and lower probability of death (adjOR 0.75; 95% CI 0.62-0.90). After propensity-score matching, a well-balanced cohort comprising 1150 men and 1150 women was analyzed, confirming the same results regarding functional outcome (3-month functional independence: OR 1.25; 95% CI 1.04-1.51), and complete recanalization (OR 1.29; 95% CI 1.09-1.53). Conclusions: Subject to the limitations of a non-randomized comparison, women with stroke due to LVO treated with mechanical thrombectomy had a better chance to achieve complete recanalization, and 3-month functional independence than men. The results could be driven by women who underwent combined treatment. © European Stroke Organisation 2022.
Entities: Chemical
Keywords:
Ischemic stroke; sex; thrombectomy
Year: 2022
PMID： 35647312 PMCID： PMC9134778 DOI： 10.1177/23969873221091648
Source DB: PubMed Journal: Eur Stroke J ISSN： 2396-9873