HHP-9 Gender Differences in Ischemic Stroke Patients with Coronary Artery Disease and Hypertension Excluded from rTPA
Abstract
Background: Coronary artery disease (CAD) and hypertension are major comorbidities affecting treatment outcome in male and female ischemic stroke patients with recombinant tissue plasminogen therapy (rTPA). However, risk factors contributing to the exclusion from rTPA for male or female ischemic stroke patients with a history of CAD and hypertension are not fully understood.
Methods: A retrospective study was conducted using data from 5469 patients with an ischemic stroke event from a regional stroke center collected from January 2010 to June 2016. Multivariate logistic regression was used to determine factors associated with gender differences in ischemic stroke patients with a history of CAD and hypertension excluded from rTPA. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for each clinical risk factor were used to predict the increasing odds of an association of a specific clinical baseline risk factor with the male or female acute ischemic stroke (AIS) patients with CAD and hypertension excluded from rTPA.
Results: In the population of male patients with CAD and hypertension, heart failure (OR = .590, 95% CI, .428-.811, P = 0.001), and diastolic blood pressure (OR = .978, 95% CI, .970-.986, P < .001) were found to be significantly associated with exclusion of rTPA. In the population of female patients with CAD and hypertension, age (OR = 1.033, 95% CI, 1.020-1.045, P < .001) and BMI (OR = 1.037, 95% CI, 1.017-1.057, P < .001), were associated with exclusion of rTPA.
Conclusion: The findings indicate that there is a gender difference for AIS patients with CAD and hypertension excluded from rTPA. Further studies to explore management strategies to eliminate gender differences will improve the inclusion of more male and female AIS patients with CAD and hypertension for rTPA therapy.
HHP-9 Gender Differences in Ischemic Stroke Patients with Coronary Artery Disease and Hypertension Excluded from rTPA
University Readiness Center Greatroom
Background: Coronary artery disease (CAD) and hypertension are major comorbidities affecting treatment outcome in male and female ischemic stroke patients with recombinant tissue plasminogen therapy (rTPA). However, risk factors contributing to the exclusion from rTPA for male or female ischemic stroke patients with a history of CAD and hypertension are not fully understood.
Methods: A retrospective study was conducted using data from 5469 patients with an ischemic stroke event from a regional stroke center collected from January 2010 to June 2016. Multivariate logistic regression was used to determine factors associated with gender differences in ischemic stroke patients with a history of CAD and hypertension excluded from rTPA. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for each clinical risk factor were used to predict the increasing odds of an association of a specific clinical baseline risk factor with the male or female acute ischemic stroke (AIS) patients with CAD and hypertension excluded from rTPA.
Results: In the population of male patients with CAD and hypertension, heart failure (OR = .590, 95% CI, .428-.811, P = 0.001), and diastolic blood pressure (OR = .978, 95% CI, .970-.986, P < .001) were found to be significantly associated with exclusion of rTPA. In the population of female patients with CAD and hypertension, age (OR = 1.033, 95% CI, 1.020-1.045, P < .001) and BMI (OR = 1.037, 95% CI, 1.017-1.057, P < .001), were associated with exclusion of rTPA.
Conclusion: The findings indicate that there is a gender difference for AIS patients with CAD and hypertension excluded from rTPA. Further studies to explore management strategies to eliminate gender differences will improve the inclusion of more male and female AIS patients with CAD and hypertension for rTPA therapy.