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Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial

BACKGROUND AND PURPOSE: Sex‐based differences in acute ischemic stroke are a well‐known phenomenon. We aimed to explore these differences between women and men in the Efficacy and Safety of MRI‐Based Thrombolysis in Wake‐Up Stroke (WAKE‐UP) trial. METHODS: We compared baseline demographic and imagin...

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Autores principales: Wouters, Anke, Scheldeman, Lauranne, Liessens, Hannelore, Dupont, Patrick, Boutitie, Florent, Cheng, Bastian, Ebinger, Martin, Endres, Matthias, Fiebach, Jochen B., Gerloff, Christian, Muir, Keith W., Nighoghossian, Norbert, Pedraza, Salvador, Simonsen, Claus Z., Thijs, Vincent, Thomalla, Götz, Lemmens, Robin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10099623/
https://www.ncbi.nlm.nih.gov/pubmed/36349887
http://dx.doi.org/10.1111/ene.15629
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author Wouters, Anke
Scheldeman, Lauranne
Liessens, Hannelore
Dupont, Patrick
Boutitie, Florent
Cheng, Bastian
Ebinger, Martin
Endres, Matthias
Fiebach, Jochen B.
Gerloff, Christian
Muir, Keith W.
Nighoghossian, Norbert
Pedraza, Salvador
Simonsen, Claus Z.
Thijs, Vincent
Thomalla, Götz
Lemmens, Robin
author_facet Wouters, Anke
Scheldeman, Lauranne
Liessens, Hannelore
Dupont, Patrick
Boutitie, Florent
Cheng, Bastian
Ebinger, Martin
Endres, Matthias
Fiebach, Jochen B.
Gerloff, Christian
Muir, Keith W.
Nighoghossian, Norbert
Pedraza, Salvador
Simonsen, Claus Z.
Thijs, Vincent
Thomalla, Götz
Lemmens, Robin
author_sort Wouters, Anke
collection PubMed
description BACKGROUND AND PURPOSE: Sex‐based differences in acute ischemic stroke are a well‐known phenomenon. We aimed to explore these differences between women and men in the Efficacy and Safety of MRI‐Based Thrombolysis in Wake‐Up Stroke (WAKE‐UP) trial. METHODS: We compared baseline demographic and imaging characteristics (visual fluid‐attenuated inversion recovery [FLAIR] positivity, relative FLAIR signal intensity, collateral status) between women and men in all screened patients. In randomized patients (i.e., those with diffusion‐weighted imaging (DWI)–FLAIR mismatch), we evaluated a modifying role of sex on the treatment effect of alteplase in multivariable logistic regression, with treatment adjusted for National Institute of Health Stroke Scale (NIHSS) score and age. Dependent variables were modified Rankin Scale (mRS) score of 0–1 at 90 days and distribution of mRS scores at 90 days. RESULTS: Of 1362 screened patients, 529 (38.8%) were women. Women were older than men, had higher baseline NIHSS scores and smoked less frequently. FLAIR positivity of the DWI lesion was equally present in women (174/529, 33.1%) and men (273/833, 33.3%; p = 1.00) and other imaging variables also did not differ between the sexes. In a total of 503 randomized patients, of whom 178 were women (35.4%), sex did not modify the treatment effect of alteplase on mRS score 0–1 or on the total distribution of mRS scores. CONCLUSION: As in many other stroke trials, more men than women were included in the WAKE‐UP trial, but the presence of a visual DWI–FLAIR mismatch and the relative FLAIR signal intensity did not differ between the sexes. The treatment effect of alteplase was not modified by sex.
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spelling pubmed-100996232023-04-14 Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial Wouters, Anke Scheldeman, Lauranne Liessens, Hannelore Dupont, Patrick Boutitie, Florent Cheng, Bastian Ebinger, Martin Endres, Matthias Fiebach, Jochen B. Gerloff, Christian Muir, Keith W. Nighoghossian, Norbert Pedraza, Salvador Simonsen, Claus Z. Thijs, Vincent Thomalla, Götz Lemmens, Robin Eur J Neurol Stroke BACKGROUND AND PURPOSE: Sex‐based differences in acute ischemic stroke are a well‐known phenomenon. We aimed to explore these differences between women and men in the Efficacy and Safety of MRI‐Based Thrombolysis in Wake‐Up Stroke (WAKE‐UP) trial. METHODS: We compared baseline demographic and imaging characteristics (visual fluid‐attenuated inversion recovery [FLAIR] positivity, relative FLAIR signal intensity, collateral status) between women and men in all screened patients. In randomized patients (i.e., those with diffusion‐weighted imaging (DWI)–FLAIR mismatch), we evaluated a modifying role of sex on the treatment effect of alteplase in multivariable logistic regression, with treatment adjusted for National Institute of Health Stroke Scale (NIHSS) score and age. Dependent variables were modified Rankin Scale (mRS) score of 0–1 at 90 days and distribution of mRS scores at 90 days. RESULTS: Of 1362 screened patients, 529 (38.8%) were women. Women were older than men, had higher baseline NIHSS scores and smoked less frequently. FLAIR positivity of the DWI lesion was equally present in women (174/529, 33.1%) and men (273/833, 33.3%; p = 1.00) and other imaging variables also did not differ between the sexes. In a total of 503 randomized patients, of whom 178 were women (35.4%), sex did not modify the treatment effect of alteplase on mRS score 0–1 or on the total distribution of mRS scores. CONCLUSION: As in many other stroke trials, more men than women were included in the WAKE‐UP trial, but the presence of a visual DWI–FLAIR mismatch and the relative FLAIR signal intensity did not differ between the sexes. The treatment effect of alteplase was not modified by sex. John Wiley and Sons Inc. 2022-11-23 2023-03 /pmc/articles/PMC10099623/ /pubmed/36349887 http://dx.doi.org/10.1111/ene.15629 Text en © 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Stroke
Wouters, Anke
Scheldeman, Lauranne
Liessens, Hannelore
Dupont, Patrick
Boutitie, Florent
Cheng, Bastian
Ebinger, Martin
Endres, Matthias
Fiebach, Jochen B.
Gerloff, Christian
Muir, Keith W.
Nighoghossian, Norbert
Pedraza, Salvador
Simonsen, Claus Z.
Thijs, Vincent
Thomalla, Götz
Lemmens, Robin
Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial
title Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial
title_full Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial
title_fullStr Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial
title_full_unstemmed Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial
title_short Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial
title_sort sex differences in imaging and clinical characteristics of patients from the wake‐up trial
topic Stroke
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10099623/
https://www.ncbi.nlm.nih.gov/pubmed/36349887
http://dx.doi.org/10.1111/ene.15629
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