Key result
Women with acute ischemic stroke receiving rtPA had better 90-day outcomes (mRS ≤1) than those on placebo (40.5% vs 30.3%, P<0.0008), a benefit not significantly seen in men (interaction P=0.04).
Why the study?
Does recombinant tissue plasminogen activator (rtPA) improve 90-day functional outcomes differently in women versus men with acute ischemic stroke?
Population
2,178 patients with acute ischemic stroke treated between 0 and 6 hours from symptom onset, pooled from the…
Comparison
Recombinant tissue plasminogen activator (rtPA) vs Placebo
Design
Meta-analysis, Randomized to rtPA versus placebo
Follow-up
90 days
Authors
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Women may derive greater rtPA benefit than men; extends pooled RCT evidence for sex as treatment-effect modifier.
Meta-Analysis (n=2,178)
randomized
Yes
Does recombinant tissue plasminogen activator (rtPA) improve 90-day functional outcomes differently in women versus men with acute ischemic stroke?
Absolute Event Rate: 40.5% vs 30.3%
p-value: p=<0.0008
In a pooled analysis of acute ischemic stroke trials, women derived a significantly greater functional benefit from rtPA therapy than men, suggesting sex may be an important factor in patient selection for thrombolysis.
Kent et al. (2004) conducted a meta-analysis in acute ischemic stroke (n=2,178). recombinant tissue plasminogen activator (rtPA) vs. placebo was evaluated on modified Rankin Score <= 1 at 90 days (p=<0.0008). Women with acute ischemic stroke receiving rtPA had better 90-day outcomes (mRS ≤1) than those on placebo (40.5% vs 30.3%, P<0.0008), a benefit not significantly seen in men (interaction P=0.04).
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