title: Does the sex of acute stroke patients influence the effectiveness of rt-PA?
abstract: BACKGROUND
  Women have been reported to show more frequent recanalization and better recovery after intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment for acute stroke compared with men. To investigate this we studied a series of stroke patients receiving IV rt-PA and undergoing acute transcranial doppler (TCD) examination.
  
  
  METHODS
  Acute stroke patients received IV rt-PA and had acute TCD examination within 4 hours of symptom onset at 4 major stroke centers. TCD findings were interpreted using the Thrombolysis in Brain Ischemia (TIBI) flow grading system. The recanalization rates, and poor 3-month outcomes (modified Rankin scale >2) of men and women were compared using the chi-square test. Multiple regression analysis was used to assess sex as a predictor of recanalization and poor 3-month outcome after controlling for age, baseline NIH Stroke Scale (NIHSS), time to treatment, hypertension, and blood glucose.
  
  
  RESULTS
  369 patients had TCD examinations before or during IV rt-PA treatment. The 199 (53.9%) men and 170 (46.1%) women had mean ages of 67 ± 13 and 70 ± 14 years, respectively. The sexes did not differ significantly in baseline stroke severity, time to TCD examination, or time to thrombolysis. Of the men, 68 (34.2%) had complete recanalization, 58 (29.1%) had partial recanalization, and 73 (36.6%) had no recanalization. Of the women, 53 (31.2%) had complete recanalization, 46 (27%) had partial recanalization, and 71 (41.8%) had no recanalization (p = 0.6). Multiple regression analyses showed no difference between the sexes in recanalization rate, time to recanalization, or clinical outcome at 3 months.
  
  
  CONCLUSIONS
  In our study; sex is not a significant predictor of recanalization rate, time to recanalization or 3-month outcome in stroke patients following IV rt-PA.
  
  
  BACKGROUND
  Data from CLOTBUST trial Clinicaltrials.gov Identifier: NCT01240356.
authors.affiliation: Department of Medicine, King Saud University, Riyadh, Saudi Arabia. faalhussain@ksu.edu.sa.
authors.forename: Fawaz
authors.initials: F
authors.lastname: Al-hussain
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Hussain
authors.forename: Carlos
authors.initials: C
authors.lastname: Molina
authors.forename: Ken
authors.initials: K
authors.lastname: Uchino
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Shuaib
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Demchuk
authors.forename: Andrei V
authors.initials: AV
authors.lastname: Alexandrov
authors.forename: Maher
authors.initials: M
authors.lastname: Saqqur
mesh_terms: D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D012737:Sex Factors; D020521:Stroke / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator