Stroke treatment outcome better for men than women

NEW YORK (Reuters Health) - For people who suffer a stroke and are treated quickly with the clot-buster drug rtPA to open up the blocked brain artery, recovery of function is likely to be better for men than women, new research shows. However, more men than women die from the stroke.

"Other studies have shown that women have worse functional outcomes after stroke; this shows that this is also true when women are treated with rtPA," said lead author Dr. Mitchell S. V. Elkind from Columbia University Medical Center in New York, in a statement.

The goal of stroke treatment is to administer a clot-busting drug within three hours after a stroke begins, so that blood flow to the brain can be restored before too much damage is done.

There are possible biological reasons why women may not respond as well as men to rtPA, Elkind explained, "including the possibility that women have higher levels of substances in the blood that can cause clots, as has been seen in women with heart disease."

The findings, which appear in the medical journal Neurology, are based on a study of 333 patients who were treated with rtPA within three hours of stroke onset.

Three months after their stroke, 47 percent of men had good functional outcomes compared with 30 percent of women.

After accounting for other factors that could affect outcome, men were two or three times more likely to have good functional recovery than women, Elkind and colleagues calculate.

As noted, however, men were 55 percent less likely to survive their stroke than women.

Still, the current findings do not suggest that rtPA should be avoided in women. "Women are definite candidates for treatment with rtPA, which is still our only approved medical treatment for acute ischemic stroke," Elkind stressed.

SOURCE: Neurology, March 13, 2007.