Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

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Effect of gender differences on prognosis of intravenous thrombolysis：Data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China)

First author：Hongyu Zhou,Weiqi Chen

Corresponding author：Yongjun Wang

Ischemic stroke Prognosis Sex Stroke management Thrombolytic therapy

essential_information

2020-07-08

Published articles

Journal：Stroke and Vascular Neurology

Publication type: Original Contributions

IF(IF): 4.081

PMID: 32641445 Link To Pubmed Full text Download

Background And Purpose

There is a growing recognition of importance of sex in stroke outcome. Recent reports suggest women who had ischemic stroke had better survival but were also more disabled and had poorer quality of life[1]. However, according to previous literature reports, the outcome of intravenous thrombolysis in female patients is different[2, 3]. Besides sex differences, age has also a possible effect on functional outcome. The purpose of this study was to compare outcome after IVT between women and men with regard to age in Chinese acute ischemic stroke patients.

Method

The patients enrolled in this study were from the Chinese Acute Ischemic Stroke thrombolysis Monitoring and Registration study (TIMS-China). The primary outcome was poor functional outcome, defined as a 3-month modified Rankin score of 3-6. The safe outcome was symptomatic intracranial hemorrhage (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 pre-onset Rankin scores, baseline NIHSS scores, TOAST types were statistically analyzed.

Conclusion

For Chinese patients with ischemic stroke, although women are older and more severe at the time of onset, the prognosis after intravenous thrombolysis is not significantly different from men.

Main results

A 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 ±11.2y vs 61.0 ±11.3y, 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 0.75-1.37). 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, pre-onset Rankin score, NIHSS score, TOAST classification and the prognosis of intravenous thrombolysis.