Sex Differences in Management and Outcomes of Cardioembolic Stroke: Post HOC Analyses of the RELAXED Study.
J Stroke Cerebrovasc Dis
; 30(4): 105613, 2021 Apr.
Article
em En
| MEDLINE
| ID: mdl-33529924
ABSTRACT
INTRODUCTION:
Experimental models have clearly demonstrated sex differences in the pathophysiology of stroke and prognosis, however clinical evidence remains elusive. In this study, we examined sex differences as a post hoc analysis of RELAXED (Recurrent Embolism Lessened by rivaroxaban, an anti-X agent, of Early Dosing for acute IS and TIA with atrial fibrillation) Study.METHODS:
We stratified study participants by sex and compared baseline and clinical characteristics as well as clinical outcomes. The primary outcome measure was a good outcome defined as a modified Rankin Scale score of 0-2 at 90 days after stroke. Secondary outcomes were mortality at 90 days, intracranial hemorrhage within 90 days, and recurrence of stroke or transient ischemic attack within 90 days. We constructed a logistic regression model to estimate the adjusted odds ratio of female patients compared with male patients for the primary and secondary outcomes.RESULTS:
Of 1303 patients, most were male (57.7%) with a mean age of 74.5 years. Female patients were older with a mean age of 80.6 ± 8.9 years and had significantly less frequent anticoagulation therapy before onset of stroke and more severe NIHSS scores. Good outcome was observed in 51.2% and 63.3% of the females and males (p < 0.0001). The adjusted odds ratio of a good outcome in females was 1.12 (95% confidence interval, 0.44-2.87) (pâ¯=â¯0.81). There were no sex differences in secondary outcomes.CONCLUSION:
Adjusted regression analysis found no sex difference in the treatment outcomes at 90 days after stroke with non-valvular atrial fibrillation.Palavras-chave
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Assunto principal:
Fibrilação Atrial
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Ataque Isquêmico Transitório
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Disparidades nos Níveis de Saúde
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Disparidades em Assistência à Saúde
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Inibidores do Fator Xa
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Rivaroxabana
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AVC Embólico
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article