Sex-Related Differences in Outcomes of Endovascular Treatment for Anterior Circulation Large Vessel Occlusion. Issue 2 (24th January 2023)

• Record Type: Journal Article
• Authors: Sun, Dapeng; Raynald, ; Huo, Xiaochuan; Jia, Baixue; Tong, Xu; Ma, Gaoting; Wang, Anxin; Ma, Ning; Gao, Feng; Mo, Dapeng; Nguyen, Thanh N.; Miao, Zhongrong
• Other Names: Miao Zhongrong author non-byline.; Gui Liqiang author non-byline.; Song Cunfeng author non-byline.; Peng Ya author non-byline.; Wu Jin author non-byline.; Zhao Shijun author non-byline.; Zhao Junfeng author non-byline.; Zhou Zhiming author non-byline.; Li Yongli author non-byline.; Jing Ping author non-byline.; Yang Lei author non-byline.; Liu Yajie author non-byline.; Zhao Qingshi author non-byline.; Liu Yan author non-byline.; Peng Xiaoxiang author non-byline.; Gao Qingchun author non-byline.; Guo Zaiyu author non-byline.; Chen Wenhuo author non-byline.; Li Weirong author non-byline.; Cheng Xiaojiang author non-byline.; Xu Yun author non-byline.; Zhang Yongqiang author non-byline.; Zhang Guilian author non-byline.; Lu Yijiu author non-byline.; Lu Xinyu author non-byline.; Wang Dengxiang author non-byline.; Wang Yan author non-byline.; Li Hao author non-byline.; Hua Yang author non-byline.; Geng Deqin author non-byline.; Yuan Haicheng author non-byline.; Wang Hongwei author non-byline.; Yang Haihua author non-byline.; Wang Zengwu author non-byline.; Wei Liping author non-byline.; Liufu Xuancong author non-byline.; Shi Xiangqun author non-byline.; Li Juntao author non-byline.; Yang Wenwu author non-byline.; Jing Wenji author non-byline.; Yong Xiang author non-byline.; Wang Leyuan author non-byline.; Li Chunlei author non-byline.; Cao Yibin author non-byline.; Zhu Qingfeng author non-byline.; Zhang Peng author non-byline.; Luo Xiang author non-byline.; Chen Shengli author non-byline.; Peng WenWu author non-byline.; Wang Lixin author non-byline.; Wen Xue author non-byline.; Shi Shugui author non-byline.; Wang Wanming author non-byline.; Bo Wang author non-byline.; Yuan Pu author non-byline.; Wang Dong author non-byline.; Guan Haitao author non-byline.; Liang Wenbao author non-byline.; Ma Daliang author non-byline.; Chen Long author non-byline.; Xiao Yan author non-byline.; Xie Xiangdong author non-byline.; Shi Zhonghua author non-byline.; Zeng Xiangjun author non-byline.; Su Fanfan author non-byline.; Chang MingZe author non-byline.; Yin Jijun author non-byline.; Sun Hongxia author non-byline.; Li Chong author non-byline.; Bi Yong author non-byline.; Xie Gang author non-byline.; Zhao Yuwu author non-byline.; Wang Chao author non-byline.; Zhang Peng author non-byline.; Wang Xianjun author non-byline.; Li Dongqun author non-byline.; Liang Hui author non-byline.; Chen Zhonglun author non-byline.; Wang Yan author non-byline.; Wang Yuxin author non-byline.; Yin Lin author non-byline.; Qiu HongKai author non-byline.; Wei Jun author non-byline.; Sun Yaxuan author non-byline.; Feng Xiaoya author non-byline.; Wu Weihua author non-byline.; Gao Lianbo author non-byline.; Ai Zhibing author non-byline.; Tan Lan author non-byline.; Ding Li author non-byline.; Liang Qilong author non-byline.; Wang Zhimin author non-byline.; Yang Jianwen author non-byline.; Xu Ping author non-byline.; Dong Wei author non-byline.; Zheng Quanle author non-byline.; Zhu Zhenyun author non-byline.; Zhao Liyue author non-byline.; Meng Qingbo author non-byline.; Wei Yuqing author non-byline.; Chen Xianglin author non-byline.; Wang Wei author non-byline.; Sun Dong author non-byline.; Yan Yongxing author non-byline.; Yuan Guangxiong author non-byline.; Yang Yadong author non-byline.; Zhou Jianfeng author non-byline.; Yang Zhi author non-byline.; Zhang Zhenzhong author non-byline.; Guan Ning author non-byline.; Wang Huihong author non-byline.;
• Is Part Of: Stroke. Volume 54:Issue 2(2023)
• Page Start: 327
• Page End: 336
• Publication Date: 2023-01-24
• Subjects: intracranial hemorrhage -- ischemic stroke -- propensity score -- reperfusion -- sex; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.122.041195
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background: Sex disparities in acute large vessel occlusion (LVO) following endovascular treatment (EVT) have been recently reported. However, there is uncertainty about the effect of sex differences on functional outcomes after EVT, particularly in an Asian population. The present study aimed to compare the clinical and safety outcomes between men and women with anterior circulation LVO treated with EVT. Methods: We analyzed data from the ANGEL-ACT (Endovascular Treatment Key Technique and Emergency Work Flow Improvement of Acute Ischemic Stroke: a Prospective Multicenter Registry Study) Registry, which was conducted at 111 hospitals from 26 provinces in China between November 2017 and March 2019. Men and women with anterior circulation LVO treated with EVT were matched using propensity scores. After a 1:1 propensity score matching, we compared the clinical outcomes including 90-day ordinal modified Rankin Scale distribution (primary outcome), procedure duration, successful reperfusion, symptomatic intracranial hemorrhage, and mortality. Furthermore, we explored sex modification on the primary outcome in subgroup analysis. Results: Of 1321 patients, 483 (36.6%) were women and 838 (63.4%) were men. The mean age for women and men were 68 and 62 years old, respectively. Among 578 patients identified after matching, there were no sex differences (men versus women) in 90-day ordinal modified Rankin Scale distribution (median [interquartile range], 4 [1–5] versus 3 [1–5], P =0.464), successful reperfusion (86.5% versus 91.0%, P =0.089), symptomatic intracranial hemorrhage (6.5% versus 7.9%, P =0.512), and mortality within 90 days (17.7% versus 17.0%, P =0.826). However, men had a longer median procedure duration than women (86 [52–128] versus 72 [48–110] minutes, β=14.51, [95% CI, 4.19–24.84]; P =0.006). Subgroup analysis showed that in patients with National Institutes of Health Stroke Scale score <15, women tended to have a better outcome than men, whereas there was no gender effect in those with National Institutes of Health Stroke Scale score ≥15 ( P for interaction=0.032). Conclusions: Overall, this matched-control study from the ANGEL-ACT study showed similar clinical outcomes between men and women with anterior circulation LVO treated with EVT. However, in the subgroup of patients presenting with lower stroke severity (ie, National Institutes of Health Stroke Scale score <15), women tended to have a better outcome than men highlighting a potential sex disparity for further investigation. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03370939.