Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets

Autor: Roberta Noseda, Federico Rea, Alberto Pagnamenta, Pamela Agazzi, Giovanni Bianco, Shairin Sihabdeen, David Seiffge, Patrik Michel, Krassen Nedeltchev, Leo Bonati, Georg Kägi, Julien Niederhauser, Thomas Nyffeler, Andreas Luft, Susanne Wegener, Ludwig Schelosky, Friedrich Medlin, Biljana Rodic, Nils Peters, Susanne Renaud, Marie-Luise Mono, Emmanuel Carrera, Urs Fischer, Alessandro Ceschi, Carlo Walter Cereda
Přispěvatelé: Noseda, R, Rea, F, Pagnamenta, A, Agazzi, P, Bianco, G, Sihabdeen, S, Seiffge, D, Michel, P, Nedeltchev, K, Bonati, L, Kägi, G, Niederhauser, J, Nyffeler, T, Luft, A, Wegener, S, Schelosky, L, Medlin, F, Rodic, B, Peters, N, Renaud, S, Mono, M, Carrera, E, Fischer, U, Ceschi, A, Cereda, C
Rok vydání: 2023
Předmět:
Zdroj: CNS Drugs. 37:351-361
ISSN: 1179-1934
1172-7047
Popis: Aim: To compare safety and functional outcomes of intravenous thrombolysis (IVT) between females and males with acute ischaemic stroke (AIS) in relation to preadmission use of antiplatelets. Methods: Multicentre cohort study of patients admitted from 1 January 2014 to 31 January 2020 to hospitals participating in the Swiss Stroke Registry, presenting with AIS and receiving IVT. Primary safety outcome was in-hospital symptomatic intracerebral haemorrhage (sICH). Primary functional outcome was functional independence at 3 months after discharge. Multivariable logistic regression models were fitted to assess the association between sex and each outcome according to preadmission use of antiplatelets. Results: The study included 4996 patients (42.51 % females, older than males, median age 79 vs 71 years, p < 0.0001). Comparable proportions of females (39.92 %) and males (40.39 %) used antiplatelets before admission (p = 0.74). In total, 3.06 % females and 2.47 % males developed in-hospital sICH (p = 0.19), with similar odds (adjusted odds ratio, [AOR] 0.93, 95 % confidence interval, [CI] 0.63–1.39). No interaction was found between sex and preadmission use of either single or dual antiplatelets in relation to in-hospital sICH (p = 0.94 and p = 0.23). Males had higher odds of functional independence at 3 months (AOR 1.34, 95 % CI 1.09–1.65), regardless of preadmission use of antiplatelets (interaction between sex and preadmission use of either single or dual antiplatelets p = 0.41 and p = 0.58). Conclusion: No sex differences were observed in the safety of IVT regarding preadmission use of antiplatelets. Males showed more favourable 3-month functional independence than females; however, this sex difference was apparently not explained by a sex-specific mechanism related to preadmission use of antiplatelets.
Databáze: OpenAIRE
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