The Impact of Sex and Gender on Stroke

Rexrode, Kathryn M.; Madsen, Tracy E.; Yu, Amy Y.X.; Carcel, Cheryl; Lichtman, Judith H.; Miller, Eliza C.

doi:10.1161/circresaha.121.319915

Cited by 242 publications

(201 citation statements)

References 187 publications

(300 reference statements)

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“…Fourth, recent studies have illustrated the gender differences on the inflammation response. Although our results indicated that there was no significant difference in the prognostic role of neutrophils in ABAO patients, further analysis was limited due to the relatively small number of female patients ( 31 ). Due to the real-world design of the present study, we cannot specifically control for gender ratio when enrolling patients.…”

Section: Discussionmentioning

confidence: 61%

Neutrophil Count Predicts Malignant Cerebellar Edema and Poor Outcome in Acute Basilar Artery Occlusion Receiving Endovascular Treatment: A Nationwide Registry-Based Study

Liu

et al. 2022

Front. Immunol.

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BackgroundAcute basilar artery occlusion (ABAO) is known to have a poor outcome with a high rate of morbidity and mortality despite endovascular treatment (EVT), highlighting the necessities of exploring factors to limit the efficacy of EVT in these patients. Cerebellar infarctions in ABAO might progress to malignant cerebellar edema (MCE), a life-threatening complication after reperfusion, posing a secondary injury to the brainstem by mass effects. Therefore, the present research aimed to explore the impacts of MCE on a long-term outcome and investigate the prognostic factors for MCE among ABAO after EVT.MethodsIn the national BASILAR registry, a total of 329 ABO patients with cerebellar infarctions treated by EVT met the inclusion criteria. The presence of MCE defined by the Jauss scale ≥4 points, was evaluated on the computed tomography performed 72 h after EVT. The adjusted odds ratio and 95% CI were obtained by logistic regression models. A favorable outcome was defined as a 90-day modified Rankin Scale score of 0–3.ResultsMCE was statistically associated with the decreased incidence of a favorable outcome [adjusted odds ratio, 0.35(95% CI, 0.18-0.68), P=0.002]. The baseline National Institutes of Health Stroke Scale score, collateral circulation, neutrophil count at admission, and recanalization status were predictors for MCE and a favorable functional status at 90 days (all P<0.05). Among all inflammatory factors, the neutrophil count achieved the highest accuracy, sensitivity, and specificity for MCE. Adding the neutrophil count status into the baseline model obviously enhanced its prediction ability for MCE and favorable outcome by increasing the area under curve and achieving both net reclassification and integrated discrimination improvement (all P<0.05). Mediation analysis indicated that MCE mediated the association between the increased neutrophil count and worse functional outcome (P=0.026).DiscussionMCE acted essential roles in worsening prognosis for ABAO after EVT. A high neutrophil count at admission was linked to MCE and a poor outcome among ABAO patients, which could be further incorporated into the clinical decision-making system and guide immunomodulation therapy.

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Section: Discussionmentioning

confidence: 61%

Neutrophil Count Predicts Malignant Cerebellar Edema and Poor Outcome in Acute Basilar Artery Occlusion Receiving Endovascular Treatment: A Nationwide Registry-Based Study

Liu

et al. 2022

Front. Immunol.

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“…Gender [39]: This feature refers to the participant's gender. The number of men is 1260, whereas the number of women is 1994.…”

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confidence: 99%

Stroke Risk Prediction with Machine Learning Techniques

Δρίτσας

Trigka

2022

Sensors

113

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A stroke is caused when blood flow to a part of the brain is stopped abruptly. Without the blood supply, the brain cells gradually die, and disability occurs depending on the area of the brain affected. Early recognition of symptoms can significantly carry valuable information for the prediction of stroke and promoting a healthy life. In this research work, with the aid of machine learning (ML), several models are developed and evaluated to design a robust framework for the long-term risk prediction of stroke occurrence. The main contribution of this study is a stacking method that achieves a high performance that is validated by various metrics, such as AUC, precision, recall, F-measure and accuracy. The experiment results showed that the stacking classification outperforms the other methods, with an AUC of 98.9%, F-measure, precision and recall of 97.4% and an accuracy of 98%.

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“…29 The epidemiology of stroke in women was reviewed extensively in 2022 in Circulation Research. 8 As this review underscored, the lifetime risk of stroke is 25.1% in women and 24.7% in men, and women face a disproportionate burden of stroke mortality and disability.…”

Section: Clinical Cvd and Cardiovascular Mortalitymentioning

confidence: 92%

Call to Action for Cardiovascular Disease in Women: Epidemiology, Awareness, Access, and Delivery of Equitable Health Care: A Presidential Advisory From the American Heart Association

Wenger¹,

Lloyd-Jones²,

Elkind³

et al. 2022

Circulation

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Addressing the pervasive gaps in knowledge and care delivery to reduce sex-based disparities and achieve equity is fundamental to the American Heart Association’s commitment to advancing cardiovascular health for all by 2024. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders around the globe to identify and remove barriers to health care access and quality for women. A concise and current summary of existing data across the areas of risk and prevention, access and delivery of equitable care, and awareness and education provides a framework to consider knowledge gaps and research needs critical toward achieving significant progress for the health and well-being of all women.

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The Impact of Sex and Gender on Stroke

Cited by 242 publications

References 187 publications

Neutrophil Count Predicts Malignant Cerebellar Edema and Poor Outcome in Acute Basilar Artery Occlusion Receiving Endovascular Treatment: A Nationwide Registry-Based Study

Neutrophil Count Predicts Malignant Cerebellar Edema and Poor Outcome in Acute Basilar Artery Occlusion Receiving Endovascular Treatment: A Nationwide Registry-Based Study

Stroke Risk Prediction with Machine Learning Techniques

Call to Action for Cardiovascular Disease in Women: Epidemiology, Awareness, Access, and Delivery of Equitable Health Care: A Presidential Advisory From the American Heart Association

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