Thrombolysis urged for women
MedWire News: Canadian registry data have confirmed the clinical trial finding that women with stroke gain greater absolute benefits from thrombolysis treatment than do men.
“Women need to be treated for stroke as soon as possible,” said study author Michael Hill from the University of Calgary in Alberta, Canada.
In line with findings from randomized trials of thrombolysis, Hill and colleagues found that among 1881 stroke patients (44% women) who did not receive tissue plasminogen activator (tPA), 69.9% of men achieved an excellent outcome at 6 months, defined as a Stroke Impact Scale-16 score higher than 75. In contrast, a significantly smaller proportion of women – 58.1% – achieved this outcome.
But among 232 patients (41% women) who did receive tPA, a similar proportion of both genders achieved excellent outcomes, at 61.7% of men and 61.0% of women. Thus, the total benefit of treatment was greater among women than men, with an absolute risk difference of 11.8%.
The current findings, which appear in the journal Neurology, allay concerns that the previously observed gender–treatment interaction was caused by the selective nature of randomized trial populations, note the researchers. They add that “consistency of effect is one of several factors that support a causal relationship,” but say that the possible biologic causes of this association “remain obscure.”
Hill said: “One social reason may be that more than 30% of women were widowed compared to 7% of men at the time of stroke, and therefore did not have a spouse who could act as a caregiver.
“Also, post-stroke depression is more common in women than in men, which slows down recovery.”
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By Eleanor McDermid