Do women benefit more from systemic thrombolysis in acute ischemic stroke? A Serbian experience with thrombolysis in ischemic stroke (SETIS) study

Jovanović, Dejana; Beslać-Bumbaširević, Lj.; Budimkic, Maja Stefanovic; Pekmezović, Tatjana; Živković, Mladen; Kostić, Vladimir

doi:10.1016/j.clineuro.2009.06.014

Cited by 30 publications

(25 citation statements)

References 18 publications

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“…But, at variance with our study, authors did not observe any sex differences for mortality. Results similar to ours were observed in smaller open-label studies on intravenous tPA, [15][16][17][18] as well as in a systematic review of 16 studies on intravenous thrombolysis, which reported no sex-based difference in functional outcome after controlling for the typical baseline imbalances between men and women. 18 Randomized clinical trials on intra-arterial thrombolysis, such as PROACT-2, 8 reached the same conclusion as that of the intravenous thrombolysis randomized clinical trial pooled analysis, 6 with regard to a similar functional outcome between sexes, with a 20% relative benefit in women and 10% in men after treatment with intra-arterial prourokinase when compared with the respective placebo counterparts.…”

Section: Discussionsupporting

confidence: 70%

Does Sex Influence the Response to Intravenous Thrombolysis in Ischemic Stroke?

Lorenzano

Ahmed

Falcou³

et al. 2013

Stroke

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Background and Purpose-Women are more likely to have a worse outcome after an acute stroke than men. Some studies have suggested that women also benefit less from intravenous thrombolysis after an acute ischemic stroke, but others found no sex differences in safety and efficacy. We aimed to evaluate differences in 3-month outcome between sexes in intravenous tissue-type plasminogen activator-treated patients registered in the Safe Implementation of Treatments in Stroke-International Stroke Thrombolysis Register. Methods-A total of 45 079 patients treated with intravenous alteplase were recorded from 2002 to 2011. Main outcome measures were symptomatic intracerebral hemorrhage, functional independence (modified Rankin Scale score, 0-2), and mortality at 3 months. Results-Among 25 777 (57.2%) men and 19 302 (42.8%) women, we found no difference in the rate of symptomatic intracerebral hemorrhage (P=0.13), a significantly higher likelihood of functional independence at 3 months in men (P<0.0001) and a higher mortality in women when compared with men (P<0.00001). After adjustment for confounding variables, we did not observe any difference between sexes in functional outcome (odds ratio, 1.03; 95% confidence interval, 0.97-1.09; P=0.39), whereas male sex was related to a higher risk of mortality (odds ratio,

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Section: Discussionsupporting

confidence: 70%

Does Sex Influence the Response to Intravenous Thrombolysis in Ischemic Stroke?

Lorenzano

Ahmed

Falcou³

et al. 2013

Stroke

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“…The registry of patients from Belgrade is also part of a prospective and ongoing, multicenter open and observational registry of all patients treated with i.v. rt-PA in Serbia [10]. …”

Section: Methodsmentioning

confidence: 99%

Intravenous Thrombolysis for Acute Cerebral Ischemia in Belgrade, Serbia: Comparison with Lille, France

Bogosavljević¹,

Bodenant

Beslac-Bumbasirevic³

et al. 2011

Eur Neurol

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Background: Worse socioeconomic situation is associated with worse outcomes in stroke cases. Whether it also influences outcomes in patients treated with intravenous thrombolysis remains unknown. The aim of this study was to test the hypothesis that outcomes are less favorable in patients treated with intravenous thrombolysis in Belgrade, Serbia, than in Lille, France. Methods: We compared outcomes at day 7 and month 3, between 123 consecutive stroke patients treated with intravenous thrombolysis in Belgrade and 273 in Lille. Results: At month 3, there was no significant difference between Belgrade and Lille in patients’ excellent outcomes [modified Rankin Scale 0–1; 49.6 vs. 45.4%, odds ratio (OR): 1.21, 95% confidence interval (CI): 0.79–1.86] or in death (11.4 vs. 16.1%, OR 0.67, 95% CI: 0.35–1.27). However, compared with a subgroup of age-matched patients from Lille, Belgrade patients tended to have worse outcomes. Patients from Belgrade were 16 years younger (p < 0.0001), more likely to be men (OR 2.40, 95% CI: 1.52–3.78), and more likely to be smokers (OR 2.24, 95% CI: 1.43–3.51). Also, a trend for a slightly higher rate of symptomatic hemorrhagic transformation was registered in this group (7.3 vs. 3.3%, OR 2.32, 95% CI: 0.90–5.99). In Belgrade, patients arrived 27 min earlier to the hospital (p < 0.0001), but their door-to-needle time was 37 min longer (p < 0.0001). Compared with a subgroup of age-matched patients from Lille, they tended to have worse outcomes. Conclusion: Intravenous thrombolysis-treated stroke patients in Belgrade have similar outcomes and rates of complications as those from Lille.

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“…Serbian Experience with Thrombolysis in Ischemic Stroke, SETIS) (11,12). Pacijenti su lečeni na Odeljenju urgentne neurologije Klinike za neurologiju Kliničkog centra Srbije u periodu od 24.2.2006. do 11.7.2015. godine prema opšteprihvaćenim kriterijumima relevantnih vodiča za lečenje AIMU koji su bili aktuelni u ispitivanom periodu (5,(13)(14)(15).…”

Section: Materijal I Metodeunclassified

Efficacy and safety of intravenous thrombolysis in young adults with acute ischemic stroke

Arsenijević¹,

Blagojevic²,

Jovanović³

2017

Med podmladak

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Introduction: Stroke in young people has a major socioeconomic impact, since up to 30% of young patients may die or have permanent sequelae with expected longer survival than older patients. Aim: The aim is to investigate the efficacy and safety of intravenous thrombolysis in the young adults with acute ischemic stroke (AIS) comparing to elderly patients. Material and Methods: A total of 403 patients suffering from AIS treated with intravenous thrombolysis, were divided by age into two groups: patients aged 18 to 45 (n = 59) and patients older than 45 years (n = 344). The functional outcome, assessed by modified Rankin scale (mRS), was used as a measure of therapy efficacy, and the presence of symptomatic intracerebral hemorrhage (sICH) and mortality as a measure of thrombolysis safety. The follow-up period was 3 months after stroke onset. Results: There were no difference between two groups of patients in excellent functional outcome (mRS ≤ 1) (p = 0.149) and good functional outcome (mRS ≤ 2) (p = 0.156), while the rate of death was significantly lower in the group of younger patients (18-45 years 5.2% vs. > 45 years 17.0% , p = 0.019). Also, there was no statistically significant difference in the presence and type of sICH between these 2 groups of patients. Conclusion: There is no significant difference in good and excellent functional outcome, as well as the incidence of sICH in young adult patients with AIS treated with intravenous thrombolysis, compared to the older patients. The fatal outcome is lower in the group of younger AIS patients.

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Do women benefit more from systemic thrombolysis in acute ischemic stroke? A Serbian experience with thrombolysis in ischemic stroke (SETIS) study

Cited by 30 publications

References 18 publications

Does Sex Influence the Response to Intravenous Thrombolysis in Ischemic Stroke?

Does Sex Influence the Response to Intravenous Thrombolysis in Ischemic Stroke?

Intravenous Thrombolysis for Acute Cerebral Ischemia in Belgrade, Serbia: Comparison with Lille, France

Efficacy and safety of intravenous thrombolysis in young adults with acute ischemic stroke

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