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Comparable effects seen with tPA in male and female stroke patients

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Contrary to some earlier reports, the results of a clinical registry study and systematic review suggest that male and female stroke patients have similar outcomes when treated with intravenous recombinant tissue plasminogen activator (tPA).

Numerous reports have established that for untreated strokes, women fare worse than their male counterparts. The impact of gender on strokes treated with tPA, by contrast, is controversial, according to the report in the June issue of Stroke.

Results from some studies have suggested that men treated with tPA fare better than women, while other findings have suggested just the opposite. To date, however, no systematic review had been done comparing thrombolysis outcomes based on gender.

Since January 2002, Dr. Pierre Marino and colleagues, from Bichat University Hospital, Paris, had collected data on all patients who received intravenous tPA at their center. In addition to analyzing these data, the team performed a systematic review of relevant observational studies identified through a search of Pub MED.

In general, there was little evidence that gender had an impact on outcomes. In an unadjusted partial meta-analysis of data from their own registry of 4074 women and 5840 men, there was a suggestion that women were less likely to experience symptomatic intracranial hemorrhage from tPA than were men.

“This systematic review, including our registry data, showed no evidence of gender differences in outcomes after intravenous recombinant tPA therapy despite well-known gender differences in untreated subjects,” the authors conclude.

Reference:
Stroke 2009;40:2104-2110.