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Verfasst von:Hametner, Christian [VerfasserIn]   i
 Ringleb, Peter A. [VerfasserIn]   i
 Kellert, Lars [VerfasserIn]   i
Titel:Sex and hemisphere
Titelzusatz:a neglected, nature-determined relationship in acute ischemic stroke
Verf.angabe:Christian Hametner, Peter Ringleb, Lars Kellert
E-Jahr:2015
Jahr: July 11, 2015
Umfang:8 S.
Teil:volume:40
 year:2015
 number:1/2
 month:07
 pages:59-66
 extent:8
Fussnoten:Gesehen am 25.03.2021
Titel Quelle:Enthalten in: Cerebrovascular diseases
Ort Quelle:Basel : Karger, 1991
Jahr Quelle:2015
Band/Heft Quelle:40(2015), 1/2 vom: Juli, Seite 59-66
ISSN Quelle:1421-9786
Abstract:Background: Sex differences in the structural connectome of the brain are clinically highly relevant, but they have mostly been neglected in stroke trials. We investigated the impact of the interaction sex-by-hemisphere on outcome in stroke patients after intravenous thrombolysis (IVT). Methods: This is an observational study based on consecutively collected supratentorial stroke patients treated with IVT (n = 1,231). The 3-month modified Rankin scale (mRS) was estimated by adjusted binary (mRS 0-2 for good outcome) and ordinal regression analysis. As baseline characteristics differ substantially between the sexes, we aimed for better covariate balance by employing coarsened exact matching. Results: Sex-by-hemisphere predicted good outcome in the entire cohort (726 left, 505 right hemispheric strokes, p value<sub>interaction</sub> 0.032) and in the matched cohort (338 left, 273 right, p value<sub>interaction</sub> 0.003). Ordinal regression suggested a comparable estimate in the matched cohort (p value<sub>interaction</sub> 0.006). Further investigation revealed relevant between-sex and within-sex risk: right hemispheric strokes in men were 1.54 times (95% confidence intervals (CIs) 1.15-2.01) more likely than in women to achieve mRS 0-2. Women with right hemispheric strokes were 0.72 times (95% CI 0.54-0.92) less likely to reach mRS 0-2 than women with left hemispheric strokes. Conversely, men with right hemispheric strokes were 1.35 times (95% CI 1.06-1.70) more likely to achieve mRS 0-2 than men with left hemispheric strokes. Conclusion: This study suggests that outcomes are different in both sexes after IVT when different hemispheres are affected. Further consideration of this hypothesis in clinical trials might help in guiding individualized, injury-specific treatment approaches for acute ischemic stroke.
DOI:doi:10.1159/000430999
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: https://doi.org/10.1159/000430999
 Volltext: https://www.karger.com/Article/FullText/430999
 DOI: https://doi.org/10.1159/000430999
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1752422414
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