Does the sex of acute stroke patients influence the effectiveness of rt-PA?

  • F. A
  • M.S. H
  • C. M
 et al. 
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Abstract

Background: Women have been reported to show more frequent recanalization and better recovery after intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment for acute stroke compared with men. To investigate this we studied a series of stroke patients receiving IV rt-PA and undergoing acute transcranial doppler (TCD) examination.Methods: Acute stroke patients received IV rt-PA and had acute TCD examination within 4 hours of symptom onset at 4 major stroke centers. TCD findings were interpreted using the Thrombolysis in Brain Ischemia (TIBI) flow grading system. The recanalization rates, and poor 3-month outcomes (modified Rankin scale >2) of men and women were compared using the chi-square test. Multiple regression analysis was used to assess sex as a predictor of recanalization and poor 3-month outcome after controlling for age, baseline NIH Stroke Scale (NIHSS), time to treatment, hypertension, and blood glucose.Results: 369 patients had TCD examinations before or during IV rt-PA treatment. The 199 (53.9%) men and 170 (46.1%) women had mean ages of 67 +/- 13 and 70 +/- 14 years, respectively. The sexes did not differ significantly in baseline stroke severity, time to TCD examination, or time to thrombolysis. Of the men, 68 (34.2%) had complete recanalization, 58 (29.1%) had partial recanalization, and 73 (36.6%) had no recanalization. Of the women, 53 (31.2%) had complete recanalization, 46 (27%) had partial recanalization, and 71 (41.8%) had no recanalization (p = 0.6). Multiple regression analyses showed no difference between the sexes in recanalization rate, time to recanalization, or clinical outcome at 3 months.Conclusions: In our study; sex is not a significant predictor of recanalization rate, time to recanalization or 3-month outcome in stroke patients following IV rt-PA.Trial registration: Data from CLOTBUST trial Clinicaltrails.gov Identifier: NCT01240356. © 2014 Al-hussain et al.; licensee BioMed Central Ltd.

Author-supplied keywords

  • *alteplase/dt [Drug Therapy]
  • *alteplase/iv [Intravenous Drug Administration]
  • *cerebrovascular accident/dt [Drug Therapy]
  • *sex
  • *stroke patient
  • Doppler echography
  • National Institutes of Health Stroke Scale
  • Rankin scale
  • age
  • aged
  • article
  • cerebrovascular accident/dt [Drug Therapy]
  • clinical effectiveness
  • disease severity
  • female
  • fibrinolytic therapy
  • glucose blood level
  • glucose/ec [Endogenous Compound] XT - cerebrovasc
  • human
  • hypertension
  • major clinical study
  • male
  • named inventories, questionnaires and rating scale
  • recanalization
  • sex difference
  • systolic blood pressure
  • thrombolysis in brain ischemia flow grading system
  • time to treatment
  • treatment outcome

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Authors

  • Al-hussain F.

  • Hussain M.S.

  • Molina C.

  • Uchino K.

  • Shuaib A.

  • Demchuk A.M.

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