Yger Marion, Januel Edouard, Checkouri Thomas, Chausson Nicolas, Smadja Didier, Caroff Jildaz, Olindo Stéphane, Marnat Gaultier, Wiener Emmanuel, Pico Fernando, Turc Guillaume, Ben Hassen Wagih, Seners Pierre, Piotin Michel, Clarençon Frédéric, Alamowitch Sonia, Gerschenfeld Gaspard
AP-HP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France.
NOVA Team, Sorbonne Université, iCRIN, Institut du Cerveau, Paris, France.
Eur Stroke J. 2025 Apr 16:23969873251332497. doi: 10.1177/23969873251332497.
A better understanding of sex-related differences remains key to improve stroke care for women. We aimed to assess the differences of prognosis, symptomatic intracranial hemorrhage (sICH) rates and process times between men and women suffering from ischemic stroke.
We performed a sex-based retrospective analysis of the French Tenecteplase Treatment in Stroke multicentric registry from 2015 to 2021. We assessed sex differences in terms of 3-month good neurological outcome (defined as modified Rankin score ⩽ 2 or back to its pre-stroke value), occurrence of sICH and process times with multivariable logistic regression analyses.
1339 consecutive patients (684 women, 655 men) received tenecteplase between 2015 and 2021, among whom 873 underwent thrombectomy. Both groups differed in terms of demographic characteristics, etiology, and unclear onset. In multivariable logistic regression analyses, women and men did not differ in terms of 3-month good neurological outcome (aOR = 0.85 [0.63-1.13]). Women were less likely to have a sICH after tenecteplase (aOR = 0.35 [0.18-0.69]) and more likely to have a stroke of unknown onset (aOR 1.44 [1.07-1.95]), but workflow metrics did not differ once stroke code was triggered.
In our study, we did not find a significant difference between women and men in terms of 3-month good outcome. However, our study size may hinder its detection. Interestingly, we observed that women had a lower rate of sICH after tenecteplase. Women's workflow metrics were similar to men's, except for a higher rate of stroke with an unknown onset.
更好地理解性别差异仍然是改善女性中风护理的关键。我们旨在评估缺血性中风男性和女性在预后、症状性颅内出血（sICH）发生率及治疗流程时间方面的差异。
我们对2015年至2021年法国中风替奈普酶治疗多中心登记研究进行了基于性别的回顾性分析。我们通过多变量逻辑回归分析评估了3个月良好神经功能结局（定义为改良Rankin评分≤2或恢复至中风前水平）、sICH的发生情况及治疗流程时间方面的性别差异。
2015年至2021年期间，1339例连续患者（684例女性，655例男性）接受了替奈普酶治疗，其中873例接受了血栓切除术。两组在人口统计学特征、病因及发病情况不明方面存在差异。在多变量逻辑回归分析中，女性和男性在3个月良好神经功能结局方面无差异（调整后比值比[aOR]=0.85[0.63 - 1.13]）。女性在接受替奈普酶治疗后发生sICH的可能性较小（aOR = 0.35[0.18 - 0.69]），且发生发病情况不明的中风的可能性较大（aOR 1.44[1.07 - 1.95]），但一旦触发中风代码，治疗流程指标并无差异。
在我们的研究中，我们未发现女性和男性在3个月良好结局方面存在显著差异。然而，我们的研究规模可能妨碍了这一差异的检测。有趣的是，我们观察到女性在接受替奈普酶治疗后sICH发生率较低。除发病情况不明的中风发生率较高外，女性的治疗流程指标与男性相似。
