Roberta Noseda, Federico Rea, Giovanni Bianco, Elias Auer, Mirjam R Heldner, Eike I Piechowiak, Tomas Dobrocky, Patrik Michel, Susanne Wegener, Hakim Baazaoui, Philipp Baumgartner, Sami Curtze, Nicolas Martinez-Majander, Miranda Nybondas, Andrea Zini, Stefano Forlivesi, Matteo Paolucci, Gian Marco De Marchis, Tolga Dittrich, Paul J Nederkoorn, Nabila Wali, Mira Katan, Stefan Engelter, Henrik Gensicke, Simon Trüssel, Alessandro Pezzini, Mauro Magoni, João Pedro Marto, Maria Brás Monteiro, Ronen R Leker, Tamer Jubeh, Visnja Padjen, Carlo W Cereda
{"title":"先前使用抗血小板的血管内治疗后结果的性别差异：EVA-TRISP注册研究","authors":"Roberta Noseda, Federico Rea, Giovanni Bianco, Elias Auer, Mirjam R Heldner, Eike I Piechowiak, Tomas Dobrocky, Patrik Michel, Susanne Wegener, Hakim Baazaoui, Philipp Baumgartner, Sami Curtze, Nicolas Martinez-Majander, Miranda Nybondas, Andrea Zini, Stefano Forlivesi, Matteo Paolucci, Gian Marco De Marchis, Tolga Dittrich, Paul J Nederkoorn, Nabila Wali, Mira Katan, Stefan Engelter, Henrik Gensicke, Simon Trüssel, Alessandro Pezzini, Mauro Magoni, João Pedro Marto, Maria Brás Monteiro, Ronen R Leker, Tamer Jubeh, Visnja Padjen, Carlo W Cereda","doi":"10.1177/23969873251346016","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study assessed sex differences in outcomes after mechanical thrombectomy (MT) with prior antiplatelet use using the EVA-TRISP multinational registry.</p><p><strong>Patients and methods: </strong>A cohort of consecutive patients (2015-2023) treated with MT was analysed by sex and prior antiplatelet use in multivariable logistic regression models. Primary outcomes were in-hospital symptomatic intracranial haemorrhage (sICH) and the 3-month modified Rankin Scale (mRS) score.</p><p><strong>Results: </strong>Among 7472 patients (47.9% females, older than males: 77 vs 72 years, <i>p</i> < 0.0001), sICH rates were similar (females 4.6%, males 4.4%, <i>p</i> = 0.405). The odds of sICH were not influenced by sex (adjusted odds ratio, aOR, 0.99, 95% confidence interval, CI, 0.77-1.28) or prior antiplatelet use (single therapy: aOR 1.28, 95% CI 0.95-1.73; dual therapy: aOR 0.81, 95% CI 0.29-2.31). No significant interactions were found between sex and antiplatelet use (<i>p</i> = 0.73 for single, <i>p</i> = 0.71 for dual therapy). Females had worse 3-month ordinal mRS scores than males (<i>p</i> < 0.0001), but the odds of a higher mRS score were not associated with sex (aOR 1.03, 95% CI 0.93-1.13) or prior antiplatelet use (single: aOR 1.03, 95% CI 0.91-1.16; dual: aOR 1.16, 95% CI 0.82-1.64). No interactions were found between sex and antiplatelet use for mRS (<i>p</i> = 0.78 for single, <i>p</i> = 0.29 for dual therapy).</p><p><strong>Discussion and conclusions: </strong>This study showed that there is no apparent interaction between patient sex and prior use of antiplatelets in relation to safety and functional outcomes of MT. Therefore, there is no reason to support a different decision-making approach by practicing physicians regarding MT in females and males previously taking antiplatelets.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"23969873251346016"},"PeriodicalIF":4.5000,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170539/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sex differences in outcomes after endovascular therapy with prior antiplatelet use: A study from the EVA-TRISP registry.\",\"authors\":\"Roberta Noseda, Federico Rea, Giovanni Bianco, Elias Auer, Mirjam R Heldner, Eike I Piechowiak, Tomas Dobrocky, Patrik Michel, Susanne Wegener, Hakim Baazaoui, Philipp Baumgartner, Sami Curtze, Nicolas Martinez-Majander, Miranda Nybondas, Andrea Zini, Stefano Forlivesi, Matteo Paolucci, Gian Marco De Marchis, Tolga Dittrich, Paul J Nederkoorn, Nabila Wali, Mira Katan, Stefan Engelter, Henrik Gensicke, Simon Trüssel, Alessandro Pezzini, Mauro Magoni, João Pedro Marto, Maria Brás Monteiro, Ronen R Leker, Tamer Jubeh, Visnja Padjen, Carlo W Cereda\",\"doi\":\"10.1177/23969873251346016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study assessed sex differences in outcomes after mechanical thrombectomy (MT) with prior antiplatelet use using the EVA-TRISP multinational registry.</p><p><strong>Patients and methods: </strong>A cohort of consecutive patients (2015-2023) treated with MT was analysed by sex and prior antiplatelet use in multivariable logistic regression models. Primary outcomes were in-hospital symptomatic intracranial haemorrhage (sICH) and the 3-month modified Rankin Scale (mRS) score.</p><p><strong>Results: </strong>Among 7472 patients (47.9% females, older than males: 77 vs 72 years, <i>p</i> < 0.0001), sICH rates were similar (females 4.6%, males 4.4%, <i>p</i> = 0.405). The odds of sICH were not influenced by sex (adjusted odds ratio, aOR, 0.99, 95% confidence interval, CI, 0.77-1.28) or prior antiplatelet use (single therapy: aOR 1.28, 95% CI 0.95-1.73; dual therapy: aOR 0.81, 95% CI 0.29-2.31). No significant interactions were found between sex and antiplatelet use (<i>p</i> = 0.73 for single, <i>p</i> = 0.71 for dual therapy). Females had worse 3-month ordinal mRS scores than males (<i>p</i> < 0.0001), but the odds of a higher mRS score were not associated with sex (aOR 1.03, 95% CI 0.93-1.13) or prior antiplatelet use (single: aOR 1.03, 95% CI 0.91-1.16; dual: aOR 1.16, 95% CI 0.82-1.64). No interactions were found between sex and antiplatelet use for mRS (<i>p</i> = 0.78 for single, <i>p</i> = 0.29 for dual therapy).</p><p><strong>Discussion and conclusions: </strong>This study showed that there is no apparent interaction between patient sex and prior use of antiplatelets in relation to safety and functional outcomes of MT. Therefore, there is no reason to support a different decision-making approach by practicing physicians regarding MT in females and males previously taking antiplatelets.</p>\",\"PeriodicalId\":46821,\"journal\":{\"name\":\"European Stroke Journal\",\"volume\":\" \",\"pages\":\"23969873251346016\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-06-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170539/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Stroke Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/23969873251346016\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Stroke Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/23969873251346016","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
本研究通过EVA-TRISP跨国登记评估了机械取栓（MT）术后既往使用抗血小板药物的结果的性别差异。患者和方法：在多变量logistic回归模型中，对一组连续接受MT治疗的患者（2015-2023）按性别和既往抗血小板使用情况进行分析。主要结局为院内症状性颅内出血（siich）和3个月修正Rankin量表（mRS）评分。结果：7472例患者中，女性占47.9%，年龄大于男性：77 vs 72岁，p p = 0.405。sICH的几率不受性别（校正优势比，aOR, 0.99, 95%可信区间，CI, 0.77-1.28）或既往抗血小板使用(单一治疗：aOR 1.28, 95% CI 0.95-1.73；双重治疗：aOR 0.81, 95% CI 0.29-2.31)。性别与抗血小板使用之间没有发现显著的相互作用（单治疗p = 0.73，双治疗p = 0.71）。女性的3个月平均mRS评分低于男性（单药组p = 0.78，双药组p = 0.29）。讨论和结论：本研究表明，患者性别和既往使用抗血小板药物与MT的安全性和功能结局之间没有明显的相互作用。因此，没有理由支持执业医生对女性和既往使用抗血小板药物的男性MT采取不同的决策方法。
Sex differences in outcomes after endovascular therapy with prior antiplatelet use: A study from the EVA-TRISP registry.
Introduction: This study assessed sex differences in outcomes after mechanical thrombectomy (MT) with prior antiplatelet use using the EVA-TRISP multinational registry.
Patients and methods: A cohort of consecutive patients (2015-2023) treated with MT was analysed by sex and prior antiplatelet use in multivariable logistic regression models. Primary outcomes were in-hospital symptomatic intracranial haemorrhage (sICH) and the 3-month modified Rankin Scale (mRS) score.
Results: Among 7472 patients (47.9% females, older than males: 77 vs 72 years, p < 0.0001), sICH rates were similar (females 4.6%, males 4.4%, p = 0.405). The odds of sICH were not influenced by sex (adjusted odds ratio, aOR, 0.99, 95% confidence interval, CI, 0.77-1.28) or prior antiplatelet use (single therapy: aOR 1.28, 95% CI 0.95-1.73; dual therapy: aOR 0.81, 95% CI 0.29-2.31). No significant interactions were found between sex and antiplatelet use (p = 0.73 for single, p = 0.71 for dual therapy). Females had worse 3-month ordinal mRS scores than males (p < 0.0001), but the odds of a higher mRS score were not associated with sex (aOR 1.03, 95% CI 0.93-1.13) or prior antiplatelet use (single: aOR 1.03, 95% CI 0.91-1.16; dual: aOR 1.16, 95% CI 0.82-1.64). No interactions were found between sex and antiplatelet use for mRS (p = 0.78 for single, p = 0.29 for dual therapy).
Discussion and conclusions: This study showed that there is no apparent interaction between patient sex and prior use of antiplatelets in relation to safety and functional outcomes of MT. Therefore, there is no reason to support a different decision-making approach by practicing physicians regarding MT in females and males previously taking antiplatelets.
期刊介绍：
Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
