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Sex Differences in Management and Outcomes of Cardioembolic Stroke: Post HOC Analyses of the RELAXED Study.
- Source :
-
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2021 Apr; Vol. 30 (4), pp. 105613. Date of Electronic Publication: 2021 Jan 30. - Publication Year :
- 2021
-
Abstract
- Introduction: Experimental models have clearly demonstrated sex differences in the pathophysiology of stroke and prognosis, however clinical evidence remains elusive. In this study, we examined sex differences as a post hoc analysis of RELAXED (Recurrent Embolism Lessened by rivaroxaban, an anti-X agent, of Early Dosing for acute IS and TIA with atrial fibrillation) Study.<br />Methods: We stratified study participants by sex and compared baseline and clinical characteristics as well as clinical outcomes. The primary outcome measure was a good outcome defined as a modified Rankin Scale score of 0-2 at 90 days after stroke. Secondary outcomes were mortality at 90 days, intracranial hemorrhage within 90 days, and recurrence of stroke or transient ischemic attack within 90 days. We constructed a logistic regression model to estimate the adjusted odds ratio of female patients compared with male patients for the primary and secondary outcomes.<br />Results: Of 1303 patients, most were male (57.7%) with a mean age of 74.5 years. Female patients were older with a mean age of 80.6 ± 8.9 years and had significantly less frequent anticoagulation therapy before onset of stroke and more severe NIHSS scores. Good outcome was observed in 51.2% and 63.3% of the females and males (p < 0.0001). The adjusted odds ratio of a good outcome in females was 1.12 (95% confidence interval, 0.44-2.87) (p = 0.81). There were no sex differences in secondary outcomes.<br />Conclusion: Adjusted regression analysis found no sex difference in the treatment outcomes at 90 days after stroke with non-valvular atrial fibrillation.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Atrial Fibrillation complications
Atrial Fibrillation diagnosis
Atrial Fibrillation mortality
Disability Evaluation
Embolic Stroke diagnosis
Embolic Stroke etiology
Embolic Stroke mortality
Female
Humans
Intracranial Hemorrhages chemically induced
Ischemic Attack, Transient diagnosis
Ischemic Attack, Transient etiology
Ischemic Attack, Transient mortality
Japan
Male
Middle Aged
Recurrence
Registries
Risk Assessment
Risk Factors
Sex Factors
Time Factors
Treatment Outcome
Atrial Fibrillation drug therapy
Embolic Stroke prevention & control
Factor Xa Inhibitors administration & dosage
Health Status Disparities
Healthcare Disparities
Ischemic Attack, Transient prevention & control
Rivaroxaban administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8511
- Volume :
- 30
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- Publication Type :
- Academic Journal
- Accession number :
- 33529924
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105613