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Sex differences in outcomes of endovascular therapy for acute vertebrobasilar occlusion: data from ANGEL-ACT Registry
Background Understanding sex disparities in stroke can identify gaps in clinical care. The objective of this study was to investigate whether sex differences could influence clinical outcomes of patients with acute vertebrobasilar artery occlusion (VBAO) who underwent endovascular therapy (EVT). Met...
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| Published in: | Journal of neurology 2024-03, Vol.271 (3), p.1376-1384 |
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| container_end_page | 1384 |
| container_issue | 3 |
| container_start_page | 1376 |
| container_title | Journal of neurology |
| container_volume | 271 |
| creator | Huo, Xiaochuan Sun, Dapeng Raynald Jia, Baixue Tong, Xu Wang, Anxin Ma, Ning Gao, Feng Mo, Dapeng Nguyen, Thanh N. Miao, Zhongrong |
| description | Background
Understanding sex disparities in stroke can identify gaps in clinical care. The objective of this study was to investigate whether sex differences could influence clinical outcomes of patients with acute vertebrobasilar artery occlusion (VBAO) who underwent endovascular therapy (EVT).
Methods
Patients were selected from the ANGEL-ACT Registry. The primary outcome was favorable functional outcome (90-day modified Rankin Scale [mRS] 0–3). Secondary outcomes included 90-day mRS distribution, excellent outcome (mRS 0–1), functional independence (mRS 0–2), early neurological improvement, recanalization, intracranial hemorrhage, and mortality within 90 days. The above outcomes were compared by two adjustment models, including (1) multivariable logistics analysis adjusting for all baseline and procedural variables with a
P
|
| doi_str_mv | 10.1007/s00415-023-12078-2 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2889239910</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2931852304</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-d1aa01a418e456cfc80daf8ab246784c5f11fae366d31a147a8359e4ecd46f303</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi0EotvCH-CALHHhEhh_JQ631aq0SCuQoJytWWdcUiXxYscV--_JsgUkDpxmpHnmnZEexl4IeCMAmrcZQAtTgVSVkNDYSj5iK6GVrIQ27WO2AqWhMsroM3ae8x0A2GXwlJ2ppjXQmHbFyhf6wbs-BEo0ecq8n3gss4_j0sfAaeriPWZfBkx8_kYJ9wceYuLoy0z8ntJMuxR3mPsjEb0fSu7j9I53OCMPKY58_fHqclutNzf8M932eU6HZ-xJwCHT84d6wb6-v7zZXFfbT1cfNutt5ZWs56oTiCBQC0va1D54Cx0Gizup68Zqb4IQAUnVdacECt2gVaYlTb7TdVCgLtjrU-4-xe-F8uzGPnsaBpwoluykta1UbSuO6Kt_0LtY0rR852SrhDVSgV4oeaJ8ijknCm6f-hHTwQlwRynuJMUtUtwvKU4uSy8fostupO7Pym8LC6BOQF5G0y2lv7f_E_sT5XyX5Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2931852304</pqid></control><display><type>article</type><title>Sex differences in outcomes of endovascular therapy for acute vertebrobasilar occlusion: data from ANGEL-ACT Registry</title><source>Springer Link</source><creator>Huo, Xiaochuan ; Sun, Dapeng ; Raynald ; Jia, Baixue ; Tong, Xu ; Wang, Anxin ; Ma, Ning ; Gao, Feng ; Mo, Dapeng ; Nguyen, Thanh N. ; Miao, Zhongrong</creator><creatorcontrib>Huo, Xiaochuan ; Sun, Dapeng ; Raynald ; Jia, Baixue ; Tong, Xu ; Wang, Anxin ; Ma, Ning ; Gao, Feng ; Mo, Dapeng ; Nguyen, Thanh N. ; Miao, Zhongrong ; ANGEL-ACT study group ; the ANGEL-ACT study group</creatorcontrib><description>Background
Understanding sex disparities in stroke can identify gaps in clinical care. The objective of this study was to investigate whether sex differences could influence clinical outcomes of patients with acute vertebrobasilar artery occlusion (VBAO) who underwent endovascular therapy (EVT).
Methods
Patients were selected from the ANGEL-ACT Registry. The primary outcome was favorable functional outcome (90-day modified Rankin Scale [mRS] 0–3). Secondary outcomes included 90-day mRS distribution, excellent outcome (mRS 0–1), functional independence (mRS 0–2), early neurological improvement, recanalization, intracranial hemorrhage, and mortality within 90 days. The above outcomes were compared by two adjustment models, including (1) multivariable logistics analysis adjusting for all baseline and procedural variables with a
P
< 0.05; (2) adjusting for the propensity score.
Results
There were 347 acute VBAO patients treated with EVT included, of whom 72 (20.7%) were women and 275 (79.3%) were men. Women were older (72[63–76] vs. 62[53–69],
P
< 0.001) and had a higher rate of atrial fibrillation (31.9% vs. 8.7%,
P
< 0.001), lower rates of underlying intracranial atherosclerotic disease (30.6% vs. 51.3%,
P
= 0.007), and tandem occlusion (8.3% vs. 21.8%,
P
= 0.009) than men. The rate of favorable outcome (mRS 0–3) was similar between women and men (41.7% vs. 51.3%, adjusted odds ratio 1.56, 95%CI: 0.83–2.95,
P
= 0.171). There were no sex differences in other clinical outcomes (all
P
> 0.05).
Conclusions
In the ANGEL-ACT registry, the percentage of men with acute VBAO undergoing EVT was approximately fourfold higher than that of women with acute VBAO undergoing EVT. Sex differences did not modify the outcomes of acute VBAO after EVT.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-023-12078-2</identifier><identifier>PMID: 37950759</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arteriosclerosis ; Cardiovascular system ; Clinical outcomes ; Gender differences ; Hemorrhage ; Medicine ; Medicine & Public Health ; Neurology ; Neuroradiology ; Neurosciences ; Occlusion ; Original Communication ; Sex differences ; Women</subject><ispartof>Journal of neurology, 2024-03, Vol.271 (3), p.1376-1384</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-d1aa01a418e456cfc80daf8ab246784c5f11fae366d31a147a8359e4ecd46f303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37950759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huo, Xiaochuan</creatorcontrib><creatorcontrib>Sun, Dapeng</creatorcontrib><creatorcontrib>Raynald</creatorcontrib><creatorcontrib>Jia, Baixue</creatorcontrib><creatorcontrib>Tong, Xu</creatorcontrib><creatorcontrib>Wang, Anxin</creatorcontrib><creatorcontrib>Ma, Ning</creatorcontrib><creatorcontrib>Gao, Feng</creatorcontrib><creatorcontrib>Mo, Dapeng</creatorcontrib><creatorcontrib>Nguyen, Thanh N.</creatorcontrib><creatorcontrib>Miao, Zhongrong</creatorcontrib><creatorcontrib>ANGEL-ACT study group</creatorcontrib><creatorcontrib>the ANGEL-ACT study group</creatorcontrib><title>Sex differences in outcomes of endovascular therapy for acute vertebrobasilar occlusion: data from ANGEL-ACT Registry</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Background
Understanding sex disparities in stroke can identify gaps in clinical care. The objective of this study was to investigate whether sex differences could influence clinical outcomes of patients with acute vertebrobasilar artery occlusion (VBAO) who underwent endovascular therapy (EVT).
Methods
Patients were selected from the ANGEL-ACT Registry. The primary outcome was favorable functional outcome (90-day modified Rankin Scale [mRS] 0–3). Secondary outcomes included 90-day mRS distribution, excellent outcome (mRS 0–1), functional independence (mRS 0–2), early neurological improvement, recanalization, intracranial hemorrhage, and mortality within 90 days. The above outcomes were compared by two adjustment models, including (1) multivariable logistics analysis adjusting for all baseline and procedural variables with a
P
< 0.05; (2) adjusting for the propensity score.
Results
There were 347 acute VBAO patients treated with EVT included, of whom 72 (20.7%) were women and 275 (79.3%) were men. Women were older (72[63–76] vs. 62[53–69],
P
< 0.001) and had a higher rate of atrial fibrillation (31.9% vs. 8.7%,
P
< 0.001), lower rates of underlying intracranial atherosclerotic disease (30.6% vs. 51.3%,
P
= 0.007), and tandem occlusion (8.3% vs. 21.8%,
P
= 0.009) than men. The rate of favorable outcome (mRS 0–3) was similar between women and men (41.7% vs. 51.3%, adjusted odds ratio 1.56, 95%CI: 0.83–2.95,
P
= 0.171). There were no sex differences in other clinical outcomes (all
P
> 0.05).
Conclusions
In the ANGEL-ACT registry, the percentage of men with acute VBAO undergoing EVT was approximately fourfold higher than that of women with acute VBAO undergoing EVT. Sex differences did not modify the outcomes of acute VBAO after EVT.</description><subject>Arteriosclerosis</subject><subject>Cardiovascular system</subject><subject>Clinical outcomes</subject><subject>Gender differences</subject><subject>Hemorrhage</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Occlusion</subject><subject>Original Communication</subject><subject>Sex differences</subject><subject>Women</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kU1v1DAQhi0EotvCH-CALHHhEhh_JQ631aq0SCuQoJytWWdcUiXxYscV--_JsgUkDpxmpHnmnZEexl4IeCMAmrcZQAtTgVSVkNDYSj5iK6GVrIQ27WO2AqWhMsroM3ae8x0A2GXwlJ2ppjXQmHbFyhf6wbs-BEo0ecq8n3gss4_j0sfAaeriPWZfBkx8_kYJ9wceYuLoy0z8ntJMuxR3mPsjEb0fSu7j9I53OCMPKY58_fHqclutNzf8M932eU6HZ-xJwCHT84d6wb6-v7zZXFfbT1cfNutt5ZWs56oTiCBQC0va1D54Cx0Gizup68Zqb4IQAUnVdacECt2gVaYlTb7TdVCgLtjrU-4-xe-F8uzGPnsaBpwoluykta1UbSuO6Kt_0LtY0rR852SrhDVSgV4oeaJ8ijknCm6f-hHTwQlwRynuJMUtUtwvKU4uSy8fostupO7Pym8LC6BOQF5G0y2lv7f_E_sT5XyX5Q</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Huo, Xiaochuan</creator><creator>Sun, Dapeng</creator><creator>Raynald</creator><creator>Jia, Baixue</creator><creator>Tong, Xu</creator><creator>Wang, Anxin</creator><creator>Ma, Ning</creator><creator>Gao, Feng</creator><creator>Mo, Dapeng</creator><creator>Nguyen, Thanh N.</creator><creator>Miao, Zhongrong</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20240301</creationdate><title>Sex differences in outcomes of endovascular therapy for acute vertebrobasilar occlusion: data from ANGEL-ACT Registry</title><author>Huo, Xiaochuan ; Sun, Dapeng ; Raynald ; Jia, Baixue ; Tong, Xu ; Wang, Anxin ; Ma, Ning ; Gao, Feng ; Mo, Dapeng ; Nguyen, Thanh N. ; Miao, Zhongrong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-d1aa01a418e456cfc80daf8ab246784c5f11fae366d31a147a8359e4ecd46f303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Arteriosclerosis</topic><topic>Cardiovascular system</topic><topic>Clinical outcomes</topic><topic>Gender differences</topic><topic>Hemorrhage</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Occlusion</topic><topic>Original Communication</topic><topic>Sex differences</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huo, Xiaochuan</creatorcontrib><creatorcontrib>Sun, Dapeng</creatorcontrib><creatorcontrib>Raynald</creatorcontrib><creatorcontrib>Jia, Baixue</creatorcontrib><creatorcontrib>Tong, Xu</creatorcontrib><creatorcontrib>Wang, Anxin</creatorcontrib><creatorcontrib>Ma, Ning</creatorcontrib><creatorcontrib>Gao, Feng</creatorcontrib><creatorcontrib>Mo, Dapeng</creatorcontrib><creatorcontrib>Nguyen, Thanh N.</creatorcontrib><creatorcontrib>Miao, Zhongrong</creatorcontrib><creatorcontrib>ANGEL-ACT study group</creatorcontrib><creatorcontrib>the ANGEL-ACT study group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huo, Xiaochuan</au><au>Sun, Dapeng</au><au>Raynald</au><au>Jia, Baixue</au><au>Tong, Xu</au><au>Wang, Anxin</au><au>Ma, Ning</au><au>Gao, Feng</au><au>Mo, Dapeng</au><au>Nguyen, Thanh N.</au><au>Miao, Zhongrong</au><aucorp>ANGEL-ACT study group</aucorp><aucorp>the ANGEL-ACT study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex differences in outcomes of endovascular therapy for acute vertebrobasilar occlusion: data from ANGEL-ACT Registry</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>271</volume><issue>3</issue><spage>1376</spage><epage>1384</epage><pages>1376-1384</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><abstract>Background
Understanding sex disparities in stroke can identify gaps in clinical care. The objective of this study was to investigate whether sex differences could influence clinical outcomes of patients with acute vertebrobasilar artery occlusion (VBAO) who underwent endovascular therapy (EVT).
Methods
Patients were selected from the ANGEL-ACT Registry. The primary outcome was favorable functional outcome (90-day modified Rankin Scale [mRS] 0–3). Secondary outcomes included 90-day mRS distribution, excellent outcome (mRS 0–1), functional independence (mRS 0–2), early neurological improvement, recanalization, intracranial hemorrhage, and mortality within 90 days. The above outcomes were compared by two adjustment models, including (1) multivariable logistics analysis adjusting for all baseline and procedural variables with a
P
< 0.05; (2) adjusting for the propensity score.
Results
There were 347 acute VBAO patients treated with EVT included, of whom 72 (20.7%) were women and 275 (79.3%) were men. Women were older (72[63–76] vs. 62[53–69],
P
< 0.001) and had a higher rate of atrial fibrillation (31.9% vs. 8.7%,
P
< 0.001), lower rates of underlying intracranial atherosclerotic disease (30.6% vs. 51.3%,
P
= 0.007), and tandem occlusion (8.3% vs. 21.8%,
P
= 0.009) than men. The rate of favorable outcome (mRS 0–3) was similar between women and men (41.7% vs. 51.3%, adjusted odds ratio 1.56, 95%CI: 0.83–2.95,
P
= 0.171). There were no sex differences in other clinical outcomes (all
P
> 0.05).
Conclusions
In the ANGEL-ACT registry, the percentage of men with acute VBAO undergoing EVT was approximately fourfold higher than that of women with acute VBAO undergoing EVT. Sex differences did not modify the outcomes of acute VBAO after EVT.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37950759</pmid><doi>10.1007/s00415-023-12078-2</doi><tpages>9</tpages></addata></record> |
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| subjects | Arteriosclerosis Cardiovascular system Clinical outcomes Gender differences Hemorrhage Medicine Medicine & Public Health Neurology Neuroradiology Neurosciences Occlusion Original Communication Sex differences Women |
| title | Sex differences in outcomes of endovascular therapy for acute vertebrobasilar occlusion: data from ANGEL-ACT Registry |
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