Sex differences in IV thrombolysis treatment for acute ischemic stroke: A systematic review and meta-analysis

Neurology
Brent StrongM J Reeves

Abstract

A prior meta-analysis of reports published between 2000 and 2008 found that women were 30% less likely to receive IV recombinant tissue plasminogen activator (rtPA) treatment for stroke than men; we updated this meta-analysis to determine if this sex difference persisted. We identified studies that reported sex-specific IV rtPA treatment rates for acute ischemic stroke published between 2008 and 2018. Eligible studies included representative populations of patients with ischemic stroke from hospital-based, registry-based, or administrative data. Random effects odds ratios (ORs) were generated to quantify sex differences. Twenty-four eligible studies were identified during this 10-year period. The summary unadjusted OR based on 17 studies with data on all ischemic stroke patients was 0.87 (95% confidence interval [CI], 0.82-0.93), indicating that women had 13% lower odds of receiving IV rtPA treatment than men. However, substantial between-study variability existed. Lower treatment odds in women were also observed in 7 studies that provided data on the subgroup of patients eligible for IV rtPA treatment, although the summary OR of 0.95 (95% CI, 0.88-1.02) was not statistically significant. Examination of time trends across 33 st...Continue Reading

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Citations

Jun 27, 2021·Revue neurologique·Q ThomasM Giroud
Sep 27, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Hong-Qiu GuZi-Xiao Li
Nov 16, 2021·Frontiers in Neurology·Lorena Jiménez-SánchezJoanna M Wardlaw

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