Do women benefit more from treatment for ischemic stroke than men?

This study investigated whether men and women respond differently to treatment for ischemic stroke. 

A stroke is a disturbance of blood flow to a part of the brain. Strokes can be caused by either a ruptured blood vessel (hemorrhagic stroke), or a blood clot that blocks blood flow (ischemic stroke).

Treatment for ischemic stroke includes an injection of tissue-type plasminogen activator (tPA; Alteplase), which breaks up blood clots. 

However, it has been suggested that men and women respond differently to ischemic stroke treatment and that one sex may benefit more from tPA, compared to the other.

This study investigated if there are differences between how men and women respond to tPA treatment after an ischemic stroke.

A total of 45,079 patients (57% of which were men) were treated with tPA after an ischemic stroke. Side effects such as brain hemorrhage and the patients’ functional independence (whether they require help carrying out daily tasks) were measured.

The study found that while there were no difference in functional outcome between men and women, men had a 19% increased risk of mortality and a 25% increased risk of brain hemorrhage compared to women.

The study concluded that tPA may have a larger beneficial treatment effect in women when compared with men. 

The study did not have a control group where patients do not receive treatment. Therefore it is not known whether men and women respond differently to an ischemic stroke itself or to the treatment. 

TPA has proven beneficial effect in treating ischemic stroke so if you or someone you know have a high risk of having a stroke, receiving treatment within the first 4 hours of stroke onset, regardless of sex, is vital.