Abstract
Intro: Women have worse functional outcomes compared to men after ischemic stroke in the setting of thrombolytic treatment. Randomized trial cohorts have suggested no difference in outcomes between men and women after EVT. We sought to determine whether these differential outcomes are seen after endovascular stroke treatment in a real-world observational cohort. Methods: We compared 90-day functional and procedural outcomes in men and women using our prospective, multi-center, observational study, BEST, that enrolled adult patients with anterior circulation stroke undergoing endovascular treatment from Nov 2017 to Sept 2018 at 12 comprehensive stroke centers across the US. The primary outcome measure was modified Rankin 0-2 (good outcome). A multivariable analysis was performed to adjust for other known predictors of outcome. Results: Among 485 subjects (51.3% female) enrolled in BEST, women were older, had higher baseline glucose levels, and smaller baseline penumbral volumes compared to men (Table 1). After controlling for age, baseline glucose, NIH Stroke scale, ASPECT score and prior stroke, we did not detect a difference in good outcome at 90 days between sexes in unadjusted (OR 0.71, 95% CI 0.49–1.04) or adjusted (OR 1.02, 95% CI 0.67-1.57) analyses. Reperfusion rates (TICI 2b/3) and rates of futile reperfusion (TICI 2b/3 with mRS 3-6) were also comparable between sexes. Conclusions: We did not detect differences in functional outcomes by sex in our large, multicenter, prospective cohort, suggesting the hypothesis that outcome disparities are attenuated by EVT.
Published Version
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