Stroke最新文献

{"title":"Evaluation of Sex-Related Differences in Cerebrovascular Bypass Patency: Review of 357 Direct Cerebral Bypasses.","authors":"Laura Stone McGuire, Tatiana Abou-Mrad, Xinjian Du, Ali Alaraj, Sepideh Amin-Hanjani, Gursant Atwal, Fady T Charbel","doi":"10.1161/STROKEAHA.124.049329","DOIUrl":"https://doi.org/10.1161/STROKEAHA.124.049329","url":null,"abstract":"<p><strong>Background: </strong>Demographics and comorbid conditions play a role in vascular health, yet their specific impact on cerebrovascular bypass patency remains unclear.</p><p><strong>Methods: </strong>An institutional database of 357 patients with intracranial bypass procedures between August 2001 and May 2022 was retrospectively reviewed. Patients with bypass for all causes (eg, aneurysm, atherosclerotic disease, moyamoya disease) were included. Medical history, surgical technique, and flow-related measurements (intraoperatively and on quantitative magnetic resonance angiography at follow-up) were compared across biological sex and in relation to bypass patency. Bonferroni correction was applied to the initial analysis (<i>P</i>≤0.00167). The remaining analyses were considered exploratory. Propensity score-matched analysis matched cardiovascular risk factors and compared women and men in bypass patency.</p><p><strong>Results: </strong>Of 357 patients, 141 were men (39.5%) and 216 were women (60.5%) with average age of 49.0±16.7 years and an average follow-up of 1.97 years. Bypass patency at last follow-up was 84.4% (n=114) for men versus 69.2% (n=148) for women (<i>P</i>=0.001). Differences were seen in underlying diagnoses, with more aneurysm and moyamoya cases represented in female sex (<i>P</i><0.001); irrespective of diagnosis, lower patency rates were seen in women when considering bypass for aneurysm (<i>P</i>=0.032), moyamoya disease (<i>P</i>=0.035), and for atherosclerotic disease (<i>P</i>=0.159). Medical comorbidities were seen at higher rates in men, with comorbidity score of 2.7 versus 2.1 (<i>P</i><0.001). Cut flow was higher in men 59.2 versus 51.1 (<i>P</i>=0.028), with no differences in intraoperative bypass flow, cut flow index, or follow-up quantitative magnetic resonance angiography. After removing cases using interposition grafts, similar differences were redemonstrated. Propensity score-matched analysis found women have a 2.71 higher chance of bypass occlusion after adjusting for cut flow index (<i>P</i>=0.017 [95% CI, 1.19-6.18]).</p><p><strong>Conclusions: </strong>Biological sex appears to play a role in bypass patency, across diagnoses. Women were less likely to have patent bypasses at the last follow-up, despite having fewer medical comorbidities than men and despite having similar intraoperative and perioperative flows.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Intermittent Hypoxia in People Living With Chronic Stroke: A Case Series.","authors":"Gregory E P Pearcey, Alexander J Barry, Milap S Sandhu, Timothy J Carroll, Elliot J Roth, W Zev Rymer","doi":"10.1161/STROKEAHA.124.046620","DOIUrl":"https://doi.org/10.1161/STROKEAHA.124.046620","url":null,"abstract":"<p><strong>Background: </strong>Acute intermittent hypoxia (AIH) is a novel therapeutic intervention that facilitates recovery of function, but the tolerability and effectiveness have not been tested in people living with chronic stroke. The purpose here was to examine whether AIH is tolerable and effective in this population.</p><p><strong>Methods: </strong>Ten participants with a unilateral, hemispheric stroke were assessed before and after 4 sessions of AIH separated by ≥48 hours in a case series at Shirley Ryan AbilityLab (Chicago). Physician-assessed signs and symptoms (assessed via: repeated symptom reviews, National Institutes of Health Stroke Scale, cranial nerve assessment, a muscle strength test, the Brunnstrom scale, sensory changes, reflexes, assessment of heart and lung status, Fugl-Meyer test, Chedoke-McMaster Stroke Assessment, Modified Ashworth Scale for Spasticity, and Delis Kaplan Executive Function System Color-Word Interference Test) and bilateral upper limb strength (grip and elbow flexion) were assessed before, ≈15 to 30 minutes, and ≈60 minutes after the intervention.</p><p><strong>Results: </strong>AIH was well-tolerated and there were no adverse events observed. After AIH, grip strength (12.91% and 16.53% improvement at 30 and 60 minutes post-AIH, respectively) and elbow flexion force (5.87% and 7.01% improvement at 30 and 60 minutes post-AIH, respectively) improved in the more-affected limb.</p><p><strong>Conclusions: </strong>AIH is potentially safe and effective for improving strength in the more-affected limb in people living with hemiparetic stroke. Future work should explore the use of AIH to enhance task-specific training-induced plasticity.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04019522.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech Therapy Combined With Cerebrolysin in Enhancing Nonfluent Aphasia Recovery After Acute Ischemic Stroke: ESCAS Randomized Pilot Study.","authors":"Volker Homberg, Dragoș Cătălin Jianu, Adina Stan, Ștefan Strilciuc, Vlad-Florin Chelaru, Michał Karliński, Michael Brainin, Wolf Dieter Heiss, Dafin F Muresanu, Pamela M Enderby","doi":"10.1161/STROKEAHA.124.049834","DOIUrl":"https://doi.org/10.1161/STROKEAHA.124.049834","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stroke-induced aphasia significantly impacts communication and quality of life. Despite the standard treatment being speech and language therapy, outcomes vary, highlighting the need for additional therapies. Cerebrolysin, a neuroprotective and neurotrophic agent, has shown potential in stroke management. This study addresses the notable gap in research about the combined use of Cerebrolysin and speech therapy, evaluating their synergistic potential in the treatment of aphasia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The ESCAS trial (The Efficacy and Safety of Cerebrolysin in the Treatment of Aphasia After Acute Ischemic Stroke), a prospective, randomized-controlled, double-blinded study was conducted in 2 Romanian stroke centers. Participants included those with left middle cerebral artery territory ischemic stroke and nonfluent aphasia, enrolled 3 to 5 days poststroke. Inclusion criteria were right-handedness and Romanian as the mother tongue. Participants received Cerebrolysin or a placebo combined with speech and language therapy in 10-day cycles over 3 intervals, and evaluations were done at baseline, 30, 60, and 90 days respectively. The main outcome measure was Western Aphasia Battery for language function. Changes at days 30, 60, and 90 compared with baseline were quantified, and the effect estimand used was the difference in means between groups. Secondary outcome measurements were the National Institutes of Health Stroke Scale for neurological deficit, the modified Rankin Scale for global disability, and the Barthel Index for activities of daily living.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 132 enrolled patients, 123 were included in the intention-to-treat analysis, and 120 in the per-protocol analysis. Overall, both groups showed improvement at subsequent visits compared with the baseline for Western Aphasia Battery and the National Institutes of Health Stroke Scale. The Cerebrolysin group showed greater improvements in Western Aphasia Battery (visit 4 mean increase of 35.579±16.316 [95% CI, 31.289-39.869] points; &lt;i&gt;P&lt;/i&gt;&lt;0.001) compared with the placebo group (20.774±12.486 [95% CI, 17.603-23.945] points; &lt;i&gt;P&lt;/i&gt;&lt;0.001), a difference in means of 14.805 (95% CI, 9.521-20.089) points (&lt;i&gt;P&lt;/i&gt;&lt;0.001). The Cerebrolysin group also showed significant improvements (higher decreases) in National Institutes of Health Stroke Scale scores compared with the placebo group (2.085 [95% CI, 1.076-3.094] points; &lt;i&gt;P&lt;/i&gt;&lt;0.001). Safety analysis raised no concerns (number of patients with adverse events &lt;i&gt;P&lt;/i&gt;=0.105, number of adverse events per patient &lt;i&gt;P&lt;/i&gt;=0.134). Additionally, the Cerebrolysin group showed greater improvements in functional independence (Barthel Index) and a trend toward reduced disability (modified Rankin Scale) compared with the placebo group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Cerebrolysin combined with speech and language therapy offers promising potential for enhancing recovery in poststroke n","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recombinant GDF11 Promotes Recovery in a Rat Permanent Ischemia Model of Subacute Stroke.","authors":"Ori S Cohen, Manisha Sinha, Yongting Wang, Tyler Daman, Pi-Chun Li, Catherine Deatherage, Berenice Charrez, Anish Deshpande, Samuel Jordan, Nyasha J Makoni, Katie LeDonne, Christopher J Dale, Laura Ben Driss, Cheryl Pan, Caterina Gasperini, Amy J Wagers, Lee L Rubin, Seth P Finklestein, Mark Allen, Richard T Lee, Anthony Sandrasagra","doi":"10.1161/STROKEAHA.124.049908","DOIUrl":"https://doi.org/10.1161/STROKEAHA.124.049908","url":null,"abstract":"<p><p><b>Background:</b> Stroke remains a leading cause of death and disability, underscoring the urgent need for treatments that enhance recovery. Growth Differentiation Factor 11 (GDF11), a member of the TGF-β superfamily, is a circulating protein involved in cellular development and tissue repair. GDF11 has gained attention for its potential regenerative properties in aging and disease contexts, making it a candidate for stroke recovery therapies. <b>Methods:</b> The therapeutic benefits of recombinant GDF11 (rGDF11) were evaluated using a rat ischemic stroke model, in which focal cerebral infarcts were induced in 8 -10 week-old young adult male Sprague-Dawley rats by permanently occluding the proximal right middle cerebral artery. Rats received single or multiple doses of rGDF11 (0.1-4 mg/kg) or vehicle 24-72 hours post-injury. Sensorimotor functions were evaluated, and brain and serum samples were examined to determine mechanism of action and identify biomarkers, using immunofluorescence, target-specific ELISAs, and an aptamer-based proteomics platform. <b>Results:</b> We confirmed rGDF11 activity in vitro and in established in vivo mouse models of cardiac hypertrophy and glucose metabolism and assessed the efficacy of rGDF11 treatment in six preclinical stroke studies, using independent Contract Research Organizations with all study animals and treatment groups blinded. All six studies revealed consistent improvement of sensorimotor outcomes with rGDF11. rGDF11-treated rats showed increased cortical vascularization and radial glia in the ventricular zone. Serum analysis revealed rGDF11 dose-dependent decreases in C-reactive protein and identified novel pharmacodynamic biomarkers and pathways associated with potential mechanisms of action of rGDF11. <b>Conclusion:</b> These results demonstrate that systemically delivered rGDF11 enhances neovascularization, reduces inflammation, promotes neurogenesis, and improves sensorimotor function post-injury in a rat model of ischemic stroke. More importantly, these data define an optimized and clinically-feasible rGDF11 dosing regimen for therapeutic development in ischemic stroke and identify a panel of candidate pharmacodynamic and mechanistic biomarkers to support clinical translation.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: Training and Infrastructure Solutions for Mechanical Thrombectomy in Low- and Middle-Income Countries.","authors":"Hisham Salahuddin, Thanh N Nguyen, Hesham E Masoud, Sheila O Martins, Ossama Y Mansour, Fawaz Al-Mufti, Syed F Zaidi","doi":"10.1161/STROKEAHA.124.047329","DOIUrl":"https://doi.org/10.1161/STROKEAHA.124.047329","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Risk Embolic Sources on Cardiac Computed Tomography in Patients With Acute Ischemic Stroke: A Case-Control Study.","authors":"Shan Sui Nio, Leon A Rinkel, Joost van Schuppen, Anje M Spijkerboer, Chiel F P Beemsterboer, Valeria Guglielmi, Berto J Bouma, S Matthijs Boekholdt, Nick H J Lobé, Ludo F M Beenen, Henk A Marquering, Charles B L M Majoie, Yvo B W E M Roos, Adrienne van Randen, R Nils Planken, Jonathan M Coutinho","doi":"10.1161/STROKEAHA.124.048349","DOIUrl":"10.1161/STROKEAHA.124.048349","url":null,"abstract":"<p><strong>Background: </strong>Cardiac computed tomography (CT) is increasingly used to search for cardioembolic sources of acute ischemic stroke (AIS). We assessed the association between high-risk cardioembolic sources on cardiac CT and AIS.</p><p><strong>Methods: </strong>We performed a case-control study using data from a prospective cohort including consecutive adult patients with suspected stroke who underwent cardiac CT acquired during the initial stroke imaging protocol between 2018 and 2020. Cases were patients with a final diagnosis of AIS. Controls were patients with a stroke mimic (SMi). We excluded patients with a transient ischemic attack. Diagnoses were established by an adjudication committee. Cardiac radiologists assessed the presence of structural high-risk sources of cardioembolism according to predefined criteria. We used the Firth penalized likelihood method to perform a logistic regression, adjusted for age, sex, and history of myocardial infarction to determine the association between high-risk embolic sources and AIS. For the primary analysis, we excluded patients with a history of atrial fibrillation. In a secondary analysis, patients with known atrial fibrillation were included.</p><p><strong>Results: </strong>Of 774 patients, we excluded 167 patients due to no written informed consent or the diagnosis of transient ischemic attack. Of 607 patients, 107 patients had known atrial fibrillation and were excluded from the primary analysis. Of 500 included patients, 375 had AIS (75%, median age 70, 61% male) and 125 SMi (25%, median age 69, 42% male). A high-risk cardioembolic source was found on CT in 32/375 (8.5%) patients with AIS and 0/125 (0%) patients with SMi (adjusted odds ratio, 23.8 [95% CI, 3.3-3032.5]). Cardiac thrombi were the most commonly observed abnormality, present in 23 (6.1%) patients with AIS and 0 (0%) patients with SMi.</p><p><strong>Conclusions: </strong>A high-risk source of cardioembolism was detected on cardiac CT more frequently in patients with AIS than in patients with SMi. These data substantiate the clinical relevance of cardioembolic sources detected on acute cardiac CT in patients with ischemic stroke.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"420-426"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Spinal Cord Infarction in a Young Patient: An Overview of Clinical Features and Management.","authors":"Christopher Chornay, Hamza Ahmed, Alexandra Kvernland, Erez Nossek, Sean Michael Kelly","doi":"10.1161/STROKEAHA.124.049502","DOIUrl":"10.1161/STROKEAHA.124.049502","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"e58-e61"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Prescription Patterns and Medication Adherence to Guideline-Directed Medical Therapy Among Patients With Ischemic Stroke.","authors":"Hend Mansoor, Daniel Manion, Anna Kucharska-Newton, Chris Delcher, Wei-Hsuan Lo-Ciganic, Gregory A Jicha, Daniela C Moga","doi":"10.1161/STROKEAHA.124.048058","DOIUrl":"10.1161/STROKEAHA.124.048058","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke is a leading cause of death and disability. Society guidelines recommend pharmacotherapies for secondary stroke prevention. However, the role of sex differences in prescription and adherence to guideline-directed medical therapies (GDMT) after ischemic stroke remains understudied. The aim of this study was to examine sex differences in prescription patterns and adherence to GDMT at 1 year after ischemic stroke in a cohort of commercially insured patients.</p><p><strong>Methods: </strong>Using the Truven Health MarketScan database from 2016 to 2020, we identified patients admitted with ischemic stroke. GDMT was defined as any statin, antihypertensive agents, or oral anticoagulant prescription within 30 days after discharge. Medication adherence was estimated using the proportion of days covered at 1 year. The proportion of days covered <0.80 was used to define nonadherence. A multivariable model adjusting for covariates was performed to identify the factors associated with nonadherence at 1 year. This analysis was restricted to new users of GDMT.</p><p><strong>Results: </strong>Among 155 220 patients admitted with acute ischemic stroke during the study period, 15 919 met the inclusion criteria. The mean age was 55.7 years, and 8218 (51.7%) were women. Women were less likely to be prescribed statins (58.0% versus 71.8%) and antihypertensive agents (27.7% versus 41.8%). In this subset of patients with atrial flutter/fibrillation, women were also less likely to be prescribed oral anticoagulants (41.2% versus 45.0%). Women were more likely to be nonadherent (ie, proportion of days covered <0.80) to statins (47.3% versus 41.6%; <i>P</i><0.0001), antihypertensives (33.3% versus 32.2%; <i>P</i>=0.005), and the combination of both (49.6% versus 45.0%; <i>P</i>=0.003). On multivariable analysis, women were likely to be nonadherent to statins and antihypertensive agents at 1 year (odds ratio, 1.23 [95% CI, 1.08-1.41]).</p><p><strong>Conclusions: </strong>In this real-world analysis of commercially insured patients with ischemic stroke, women were less likely initiated on GDMT within 30 days after discharge. Women were more likely to be nonadherent to statins and antihypertensive agents at 1 year. Future efforts and novel interventions are needed to understand the reasons and minimize these disparities.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"318-325"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in the Pre- and In-Hospital Setting of Patients With Stroke Are Driven by Higher Age and Stroke Severity.","authors":"Laura P Westphal, Lilian Rüttener, Tim Gasser, Andreas R Luft, Ulrike Held, Susanne Wegener","doi":"10.1161/STROKEAHA.124.048303","DOIUrl":"10.1161/STROKEAHA.124.048303","url":null,"abstract":"<p><strong>Background: </strong>Sex critically determines stroke pathophysiology and recovery. To reveal potential gaps in stroke care, we analyzed sex-specific differences in the stroke patient hospital admission and treatment process.</p><p><strong>Methods: </strong>In this single-center retrospective analysis, we screened all patients referred to our stroke center between 2014 and 2020 with suspicion of stroke (n=7112). Patients with different cerebrovascular events and stroke mimics were included. We collected demographic hospitalization and 90-day follow-up data and stratified results according to sex. In a logistic regression analysis for 90-day functional outcome, we estimated the effect of sex corrected for the clinically most relevant confounders.</p><p><strong>Results: </strong>Of 7102 patients, 56.7% were male and 43.3% female. Women were older (median, 76.3 years; interquartile range (IQR), 64-84, versus 70.7; IQR, 59-79; <i>P</i><0.001), and lived more often in nursing homes before the event (10.5% versus 3.8%; <i>P</i><0.001). Among patients with acute ischemic stroke (n=4515), women had more often a large vessel occlusion (38.6% versus 34.8%; <i>P</i>=0.015), a higher stroke severity (National Institutes of Health Stroke Scale score, 4; IQR, 1-12 versus 3; IQR, 1-8; <i>P</i><0.001), and were treated more often with endovascular treatment (21.4% versus 17.3%; <i>P</i>=0.001). Onset-to-door, onset-to-treatment, and door-to-treatment times were significantly longer in women. A favorable 90-day functional outcome (modified Rankin Scale score 0-2) occurred more often in men (73.9% versus 64.9%; <i>P</i><0.001). When correcting for confounders in a multivariable logistic regression, age, admission National Institutes of Health Stroke Scale, and prestroke modified Rankin Scale remained highly (<i>P</i><0.001), large vessel occlusion and arterial hypertension moderately significant predictors for 90-day functional outcome (<i>P</i><0.05), whereas female sex was not. This could be confirmed when analyzing different patient age groups separately in multivariable logistic regression subgroup analyses. An interaction-term analysis revealed no additional association between age and female sex (OR, 0.99; <i>P</i>=0.815).</p><p><strong>Conclusions: </strong>Although treatment and outcome parameters seem to be in favor of men, most can be explained by older age, poorer prestroke independence, higher stroke severity, and more large vessel occlusion in women. Sex was not independently associated with worse 90-day functional outcome in women.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"256-264"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-Core Ischemic Stroke Endovascular Treatment: A Science Advisory From the American Heart Association.","authors":"Nestor R Gonzalez, Pooja Khatri, Gregory W Albers, Oana M Dumitrascu, Mayank Goyal, Anne Leonard, Michael H Lev, Renee Martin, Chi-Hong Tseng","doi":"10.1161/STR.0000000000000481","DOIUrl":"10.1161/STR.0000000000000481","url":null,"abstract":"<p><p>Several trials of endovascular treatment for patients with large-core acute ischemic stroke have been completed. Whereas future stroke clinical guidelines will provide specific recommendations, this advisory aims to summarize the results of these trials, analyze the commonalities and differences among the studies, and discuss the clinical implications of these new results.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"e87-e97"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}