Key result
Female sex was independently associated with a higher risk of poor functional outcome at 3 months compared to male sex in patients with ischemic stroke (OR 1.54), but this difference was not observed in patients with intracerebral hemorrhage.
Why the study?
Identifying the complexities of the effect of sex on stroke risk, etiology, and lesion progression may advance treatment and care for patients with ischemic stroke and non-traumatic intracerebral hemorrhage.
Does female sex influence 3-month functional outcome in patients with ischemic stroke and intracerebral hemorrhage?
Cohort (n=5,021)
No
Does female sex influence 3-month functional outcome in patients with ischemic stroke and intracerebral hemorrhage?
Odds Ratio: 1.54 (95% CI 1.32–1.8)
Absolute Event Rate: 55.6% vs 43.6%
p-value: p=<0.0001
Female sex is independently associated with worse 3-month functional outcomes in ischemic stroke, but not in intracerebral hemorrhage, highlighting the need for sex-specific considerations in stroke prognosis.
Women with IS may face worse 3-month outcomes; leaves open whether inflammation or atrial markers warrant sex-specific trials before practice change.
Identifying the complexities of the effect of sex on stroke risk, etiology, and lesion progression may lead to advances in the treatment and care of ischemic stroke (IS) and non-traumatic intracerebral hemorrhage patients (ICH). We studied the sex-related discrepancies on the clinical course of patients with IS and ICH, and we also evaluated possible molecular mechanisms involved. The study’s main variable was the patient’s functional outcome at 3-months. Logistic regression models were used in order to study the influence of sex on different inflammatory, endothelial and atrial dysfunction markers. We recruited 5,021 patients; 4,060 IS (54.8% male, 45.2% female) and 961 ICH (57.1% male, 42.9% female). Women were on average 5.7 years older than men (6.4 years in IS, 5.1 years in ICH), and more likely to have previous poor functional status, to suffer atrial fibrillation and to be on anticoagulants. IS patients showed sex-related differences at 3-months regarding poorer outcome (55.6% women, 43.6% men, p<0.0001), but this relationship was not found in ICH (56.8% vs. 61.9%, p=0.127). In IS, women had higher levels of proBNP and 3-months worse outcome in both cardioembolic and non-cardioembolic stroke patients. Stroke patients showed sex-related differences in prehospital data, clinical variables and molecular markers, but only IS patients presented independent sex-related differences in 3-months poor outcome and mortality. There was a relationship between the molecular marker of atrial dysfunction proBNP and worse functional outcome in women, resulting in a possible indicator of increased dysfunction.
No takes yet. Share an insight, caveat, or question.
Rodríguez‐Castro et al. (2019) conducted a cohort in Ischemic stroke and non-traumatic intracerebral hemorrhage (n=5,021). Female sex vs. Male sex was evaluated on Poor functional outcome (mRS > 2) at 3 months in ischemic stroke patients (OR 1.54, 95% CI 1.32-1.80, p=<0.0001). Female sex was independently associated with a higher risk of poor functional outcome at 3 months compared to male sex in patients with ischemic stroke (OR 1.54), but this difference was not observed in patients with intracerebral hemorrhage.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: