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Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets
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 pa...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126038/ https://www.ncbi.nlm.nih.gov/pubmed/36976463 http://dx.doi.org/10.1007/s40263-023-00997-7 |
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author | Noseda, Roberta Rea, Federico Pagnamenta, Alberto Agazzi, Pamela Bianco, Giovanni Sihabdeen, Shairin Seiffge, David Michel, Patrik Nedeltchev, Krassen Bonati, Leo Kägi, Georg Niederhauser, Julien Nyffeler, Thomas Luft, Andreas Wegener, Susanne Schelosky, Ludwig Medlin, Friedrich Rodic, Biljana Peters, Nils Renaud, Susanne Mono, Marie-Luise Carrera, Emmanuel Fischer, Urs Ceschi, Alessandro Cereda, Carlo Walter |
author_facet | Noseda, Roberta Rea, Federico Pagnamenta, Alberto Agazzi, Pamela Bianco, Giovanni Sihabdeen, Shairin Seiffge, David Michel, Patrik Nedeltchev, Krassen Bonati, Leo Kägi, Georg Niederhauser, Julien Nyffeler, Thomas Luft, Andreas Wegener, Susanne Schelosky, Ludwig Medlin, Friedrich Rodic, Biljana Peters, Nils Renaud, Susanne Mono, Marie-Luise Carrera, Emmanuel Fischer, Urs Ceschi, Alessandro Cereda, Carlo Walter |
author_sort | Noseda, Roberta |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40263-023-00997-7. |
format | Online Article Text |
id | pubmed-10126038 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-101260382023-04-26 Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets Noseda, Roberta Rea, Federico Pagnamenta, Alberto Agazzi, Pamela Bianco, Giovanni Sihabdeen, Shairin Seiffge, David Michel, Patrik Nedeltchev, Krassen Bonati, Leo Kägi, Georg Niederhauser, Julien Nyffeler, Thomas Luft, Andreas Wegener, Susanne Schelosky, Ludwig Medlin, Friedrich Rodic, Biljana Peters, Nils Renaud, Susanne Mono, Marie-Luise Carrera, Emmanuel Fischer, Urs Ceschi, Alessandro Cereda, Carlo Walter CNS Drugs Original Research Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40263-023-00997-7. Springer International Publishing 2023-03-28 2023 /pmc/articles/PMC10126038/ /pubmed/36976463 http://dx.doi.org/10.1007/s40263-023-00997-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Article Noseda, Roberta Rea, Federico Pagnamenta, Alberto Agazzi, Pamela Bianco, Giovanni Sihabdeen, Shairin Seiffge, David Michel, Patrik Nedeltchev, Krassen Bonati, Leo Kägi, Georg Niederhauser, Julien Nyffeler, Thomas Luft, Andreas Wegener, Susanne Schelosky, Ludwig Medlin, Friedrich Rodic, Biljana Peters, Nils Renaud, Susanne Mono, Marie-Luise Carrera, Emmanuel Fischer, Urs Ceschi, Alessandro Cereda, Carlo Walter Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets |
title | Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets |
title_full | Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets |
title_fullStr | Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets |
title_full_unstemmed | Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets |
title_short | Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets |
title_sort | sex differences in outcomes of intravenous thrombolysis in acute ischemic stroke patients with preadmission use of antiplatelets |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126038/ https://www.ncbi.nlm.nih.gov/pubmed/36976463 http://dx.doi.org/10.1007/s40263-023-00997-7 |
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