Background and purpose We sought to investigate whether there are gender differences in clinical outcome after stroke due to large vessel occlusion (LVO) after mechanical thrombectomy (EVT) in a large population of real-world patients.Methods From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke due to large vessel occlusion. We compared clinical and safety outcomes in men and women who underwent EVT alone or in combination with intravenous thrombolysis (IVT) in the total population and in a Propensity Score matched set.Results Among 3422 patients included in the study, 1801 (52.6%) were women. Despite older age at onset (mean 72.4 vs 68.7; p < 0.001), and higher rate of atrial fibrillation (41.7% vs 28.6%; p < 0.001), women had higher probability of 3-month functional independence (adjusted odds ratio-adjOR 1.19; 95% CI 1.02-1.38), of complete recanalization (adjOR 1.25; 95% CI 1.09-1.44) and lower probability of death (adjOR 0.75; 95% CI 0.62-0.90). After propensity-score matching, a well-balanced cohort comprising 1150 men and 1150women was analyzed, confirming the same results regarding functional outcome (3-month functional independence: OR 1.25; 95% CI 1.04-1.51), and complete recanalization (OR 1.29; 95% CI 1.09-1.53).Conclusions Subject to the limitations of a non-randomized comparison, women with stroke due to LVO treated with mechanical thrombectomy had a better chance to achieve complete recanalization, and 3-month functional independence than men. The results could be driven by women who underwent combined treatment.

Sex differences in outcome after thrombectomy for acute ischemic stroke. A propensity score-matched study / Ilaria Casetta; Enrico Fainardi; Giovanni Pracucci; Valentina Saia; Fabrizio Sallustio; Valerio da Ros; Sergio Nappini; Patrizia Nencini; Guido Bigliardi; Sergio Vinci; Francesco Grillo; Sandra Bracco; Rossana Tassi; Mauro Bergui; Paolo Cerrato; Andrea Saletti; Alessandro De Vito; Roberto Gasparotti; Mauro Magoni; Luigi Simonetti; Andrea Zini; Maria Ruggiero; Marco Longoni; Lucio Castellan; Laura Malfatto; Paola Castellini; Mirco Cosottini; Alessio Comai; Enrica Franchini; Emilio Lozupone; Giacomo Della Marca; Edoardo Puglielli; Alfonsina Casalena; Claudio Baracchini; Daniele Savio; Enrica Duc; Giuseppe Ricciardi; Manuel Cappellari; Luigi Chiumarulo; Marco Petruzzellis; Anna Cavallini; Nicola Cavasin; Adriana Critelli; Nicola Burdi; Giovanni Boero; Andrea Giorgianni; Maurizio Versino; Francesco Biraschi; Ettore Nicolini; Simone Comelli; Maurizio Melis; Riccardo Padolecchia; Tiziana Tassinari; Nunzio Paolo Nuzzi; Simona Marcheselli; Simona Sacco; Paolo Invernizzi; Ivan Gallesio; Delfina Ferrandi; Maria Fancello; Maria Valeria Saddi; Monia Russo; Aldo Pischedda; Antonio Baule; Marina Mannino; Francesco Florio; Vincenzo Inchingolo; Maria Elena Flacco; Daniele Romano; Umberto Silvagni; Domenico Inzitari; Salvatore Mangiafico; Danilo Toni. - In: EUROPEAN STROKE JOURNAL. - ISSN 2396-9881. - ELETTRONICO. - 7:(2022), pp. 151-157. [10.1177/23969873221091648]

Sex differences in outcome after thrombectomy for acute ischemic stroke. A propensity score-matched study

Enrico Fainardi;Giovanni Pracucci;Valentina Saia;Patrizia Nencini;Francesco Grillo;Rossana Tassi;Claudio Baracchini;Anna Cavallini;Maria Fancello;Domenico Inzitari;Salvatore Mangiafico;
2022

Abstract

Background and purpose We sought to investigate whether there are gender differences in clinical outcome after stroke due to large vessel occlusion (LVO) after mechanical thrombectomy (EVT) in a large population of real-world patients.Methods From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke due to large vessel occlusion. We compared clinical and safety outcomes in men and women who underwent EVT alone or in combination with intravenous thrombolysis (IVT) in the total population and in a Propensity Score matched set.Results Among 3422 patients included in the study, 1801 (52.6%) were women. Despite older age at onset (mean 72.4 vs 68.7; p < 0.001), and higher rate of atrial fibrillation (41.7% vs 28.6%; p < 0.001), women had higher probability of 3-month functional independence (adjusted odds ratio-adjOR 1.19; 95% CI 1.02-1.38), of complete recanalization (adjOR 1.25; 95% CI 1.09-1.44) and lower probability of death (adjOR 0.75; 95% CI 0.62-0.90). After propensity-score matching, a well-balanced cohort comprising 1150 men and 1150women was analyzed, confirming the same results regarding functional outcome (3-month functional independence: OR 1.25; 95% CI 1.04-1.51), and complete recanalization (OR 1.29; 95% CI 1.09-1.53).Conclusions Subject to the limitations of a non-randomized comparison, women with stroke due to LVO treated with mechanical thrombectomy had a better chance to achieve complete recanalization, and 3-month functional independence than men. The results could be driven by women who underwent combined treatment.
2022
7
151
157
Ilaria Casetta; Enrico Fainardi; Giovanni Pracucci; Valentina Saia; Fabrizio Sallustio; Valerio da Ros; Sergio Nappini; Patrizia Nencini; Guido Bigliardi; Sergio Vinci; Francesco Grillo; Sandra Bracco; Rossana Tassi; Mauro Bergui; Paolo Cerrato; Andrea Saletti; Alessandro De Vito; Roberto Gasparotti; Mauro Magoni; Luigi Simonetti; Andrea Zini; Maria Ruggiero; Marco Longoni; Lucio Castellan; Laura Malfatto; Paola Castellini; Mirco Cosottini; Alessio Comai; Enrica Franchini; Emilio Lozupone; Giacomo Della Marca; Edoardo Puglielli; Alfonsina Casalena; Claudio Baracchini; Daniele Savio; Enrica Duc; Giuseppe Ricciardi; Manuel Cappellari; Luigi Chiumarulo; Marco Petruzzellis; Anna Cavallini; Nicola Cavasin; Adriana Critelli; Nicola Burdi; Giovanni Boero; Andrea Giorgianni; Maurizio Versino; Francesco Biraschi; Ettore Nicolini; Simone Comelli; Maurizio Melis; Riccardo Padolecchia; Tiziana Tassinari; Nunzio Paolo Nuzzi; Simona Marcheselli; Simona Sacco; Paolo Invernizzi; Ivan Gallesio; Delfina Ferrandi; Maria Fancello; Maria Valeria Saddi; Monia Russo; Aldo Pischedda; Antonio Baule; Marina Mannino; Francesco Florio; Vincenzo Inchingolo; Maria Elena Flacco; Daniele Romano; Umberto Silvagni; Domenico Inzitari; Salvatore Mangiafico; Danilo Toni
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1285713
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