2025 article

Sex-Related Differences in Endovascular Treatment Outcomes for Acute Large Infarcts: The ANGEL-ASPECT Subanalysis

Dapeng Sun, Xin Guo, Ling Li, Liwen Jiao, Thanh N. Nguyen, Mohamad K. Abdalkader, Yuesong Pan, Mengxing Wang, Gang Luo, Baixue Jia, Xu Tong, Ning Ma, Feng Gao, Dapeng Mo, Raynald, Xiaochuan Huo, Zhongrong Miao, Guangxiong Yuan, Hongxing Han, Wenhuo Chen, Ming Wei, Jiangang Zhang, Zhiming Zhou, Xiaoxi Yao, Guoqing Wang, Weigen Song, Xueli Cai, Guangxian Nan, Di Li, Alvin Yi-Chou Wang, Wentong Ling, Chuwei Cai, Changming Wen, En Wang, Liyong Zhang, Changchun Jiang, Yajie Liu, Geng Liao, Tianxiao Li, Shudong Liu, Jinglun Li, Yaxuan Sun, Na Xu, Zongen Gao, Dongsheng Ju, Cunfeng Song, Jinggang Xuan, Feng Zhou, Qing Shi, Jun Luo, Yan Liu, Zaiyu Guo, Tong Li, Hongbo Zheng, Linzhi Dai, Junfeng Zhao, Liqiang Gui, Xiaokun Geng, Yufeng Tang, Congguo Yin, Hua Guang Yang

5Citations signalées, ce qui n’est pas une note de qualité

8Institutions déclarées

2Pays d’affiliation déclarés

Rattachement africain : cn, us. Niveau de preuve : code pays fourni par la source.

Le résumé fourni par la source

BACKGROUND: The outcomes of endovascular therapy (EVT) across sexes for large infarcts remain unclear. This study aimed to evaluate the impact of sex on the outcomes of EVT or medical management for patients with large infarcts. METHODS: In this secondary analysis of the ANGEL-ASPECT (Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core) randomized controlled trial conducted at 46 stroke centers across China between October 2, 2020, and May 18, 2022, we compared baseline characteristics and clinical outcomes between male and female patients, and each cohort further divided into EVT and medical management groups. The primary outcome was the 90-day modified Rankin Scale score distribution. Safety outcomes included symptomatic intracranial hemorrhage within 48 hours and mortality within 90 days. RESULTS: There were 176 of 455 patients enrolled in the ANGEL-ASPECT trial who were female patients. There were 54.0% (95/176) of female patients and 48.4% (135/279) of male patients who underwent EVT. The treatment effect of EVT did not vary in both sexes with large infarcts (all P >0.05 for interaction). Compared with medical management, EVT improved 90-day functional outcomes for both male patients (3 [2–5] versus 4 [3–5]; common odds ratio, 1.94 [95% CI, 1.27–2.97]; P =0.002) and female patients (4 [3–6] versus 5 [4–6]; common odds ratio, 2.50 [95% CI, 1.41–4.45]; P =0.002). The symptomatic intracranial hemorrhage rate was not different in both treatment groups across both sexes (male patients, 5.2% versus 2.8%; odds ratio, 2.05 [95% CI, 0.56–7.50]; P =0.278; female patients, 7.4% versus 2.5%; odds ratio, 2.89 [95% CI, 0.55–15.14]; P =0.210). CONCLUSIONS: In patients with large ischemic core, the treatment effect of EVT did not differ between female and male patients, with better outcomes with EVT versus medical management, without an increased risk of symptomatic intracranial hemorrhage. These findings emphasize the need for equal attention and care for both sexes with large infarcts in clinical practice. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04551664.

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DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref: Sex-Related Differences in Endovascular Treatment Outcomes for Acute Large Infarcts: The ANGEL-ASPECT Subanalysis
Date Crossref: 01/08/2025
Éditeur: Ovid Technologies (Wolters Kluwer Health)
Type: journal-article

Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.

Où se fait cette recherche

Capital Medical University China National Clinical Research Center for Neurological Diseases (D.S. pays non établi dans la notice
Université ou école supérieure
Beijing Tian Tan Hospital pays non établi dans la notice
Établissement de santé
National Clinical Research pays non établi dans la notice
Structure de recherche
Beijing Fengtai Hospital pays non établi dans la notice
Établissement de santé
Affiliated Hospital of Hebei University Department of Neurology pays non établi dans la notice
Établissement de santé
Boston Medical Center Department of Neurology pays non établi dans la notice
Établissement de santé
Tufts Medical Center pays non établi dans la notice
Établissement de santé
Beijing Anzhen Hospital pays non établi dans la notice
Établissement de santé
Beijing Fengtai You’anmen Hospital Department of Neurointervention pays non établi dans la notice
Établissement de santé

China National Clinical Research Center for Neurological Diseases (D.S. — Capital Medical University, Beijing Tian Tan Hospital et National Clinical Research, avec 6 autres affiliations.

Une affiliation ne permet pas de déduire la nationalité d’un auteur.

Les sujets associés

Acute Ischemic Stroke ManagementCerebrovascular and Carotid Artery DiseasesIntracerebral and Subarachnoid Hemorrhage Research

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