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Treatment Gap Remains in Stroke Care Between Men and Women

Size of this difference has narrowed compared with studies published before 2008

WEDNESDAY, June 10, 2020 (HealthDay News) — Pooled data from recent studies show that women with acute stroke are less likely to be treated with intravenous (IV) thrombolysis compared with men, according to a review published online June 10 in Neurology.

Brent Strong, from Michigan State University in East Lansing, and colleagues conducted a systematic literature review to identify studies assessing sex-specific IV recombinant tissue plasminogen activator (rtPA) treatment rates for acute ischemic stroke published between 2008 and 2018.

The researchers identified 24 eligible studies. In a pooled analysis using data from 17 studies (with substantial between-study variability), the unadjusted odds ratio was 0.87 (95 percent confidence interval, 0.82 to 0.93), indicating that women had lower odds of receiving IV rtPA treatment than men. In seven studies with data on IV rtPA treatment-eligible patients, lower treatment odds were also seen in women, although the summary odds ratio of 0.95 (95 percent confidence interval, 0.88 to 1.02) was not statistically significant. When assessing time trends across 33 studies published between 2000 and 2018, the sex difference had narrowed in more recent years.

“Missed opportunities to deliver IV rtPA could have greater consequences in women because they have poorer stroke outcomes than men but derive at least equivalent treatment benefit,” the authors write.

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