Thrombolytic administration in female Type 2 diabetic patients with acute ischemic stroke was associated with increased 90-day mortality (OR 1.72; 95% CI 1.06-2.76; p=0.03).
Observational (n=5,226)
No
Does thrombolytic administration have sex-specific effects on recurrent ischemic stroke risk and survival in Type 2 diabetic patients?
Thrombolytic administration in Type 2 diabetic patients with acute ischemic stroke may have sex-specific effects, increasing 90-day mortality in females while delaying recurrence in males.
Estimación del efecto: OR 1.72 (95% CI 1.06 - 2.76)
valor p: p=0.03
Abstract Background Recent meta-analyses indicate that women with Type 2 diabetes have increased risk of ischemic stroke compared to men. However, our understanding of sex-specific differences in recurrent ischemic stroke risk and survival in this population is limited. Methods A retrospective observational analysis at a tertiary-care hospital system was conducted between December 2013 – December 2023 to identify sex-specific associations between clinical parameters and recurrent ischemic stroke risk and survival in Type 2 diabetic patients. Multivariate logistic regression and Kaplan-Meier analysis were performed to predict recurrence risk and survival outcomes. Results We identified 5,226 Type 2 diabetic patients with acute ischemic stroke, with 690 cases of recurrent ischemic stroke. Patient sex was not independently associated with recurrence risk or 90-day mortality. Sex-specific models indicated that thrombolytic administration was associated with increased likelihood of 90-day mortality following first stroke for female patients only (OR: 1.72, 95% CI: 1.06 – 2.76, p = 0.03). There were no significant differences in regression model performance in prediction of recurrent ischemic stroke among the general and sex-specific models based on receiver operating curves (0.70 ≤ AUC ≤ 0.80). Thrombolytic administration was significantly associated with time to recurrence for male (HR: 0.47, 95% CI: 0.24 – 0.93), but not female patients. Diabetic males who received a thrombolytic at first ischemic stroke had significantly longer time to recurrence compared to diabetic female patients receiving thrombolysis (p = 0.049). Conclusion Our findings provide evidence of sex-specific differences in time to recurrent ischemic stroke based on thrombolytic administration and patient age. Conflict of interest Thilan Tudor: This research was funded through a FOCUS Medical Student Fellowship in Women's Health supported by the Edna G. Kynett Memorial Foundation. Manasa Kadiyala: nothing to disclose.
Tudor et al. (Fri,) conducted a observational in Type 2 diabetes with acute ischemic stroke (n=5,226). Thrombolytic administration vs. No thrombolytic administration / male patients was evaluated on 90-day mortality following first stroke for female patients (OR 1.72, 95% CI 1.06 - 2.76, p=0.03). Thrombolytic administration in female Type 2 diabetic patients with acute ischemic stroke was associated with increased 90-day mortality (OR 1.72; 95% CI 1.06-2.76; p=0.03).