Men are more likely than women to benefit from the use of a clot-busting drug after stroke, according to a study published in the March 13, 2007, issue of Neurology®, the scientific journal of the American Academy of Neurology.
The study involved 333 people who were treated with the drug tissue plasminogen activator (tPA) within three hours after stroke.
The study found men were more than three times as likely as women to achieve functional independence at three months after tPA treatment, despite the fact that fewer men than women survived three months after treatment.
"Other studies have shown that women have worse outcomes after stroke; this shows that this is also true when women are treated with tPA," said study author Mitchell S. V. Elkind, MD, MS, Associate Professor of Neurology at Columbia University Medical Center, and Fellow of the American Academy of Neurology. "There are potential biological reasons why women may not respond as well as men to tPA, including the possibility that women have higher levels of substances in the blood that can cause blood clots, as has been seen in women with heart disease."
Elkind says it is possible that postmenopausal women, whether or not on hormone replacement therapy (HRT), are at greater risk of not responding well to tPA.
The study also found those with stroke in the left side of the brain, compared to stroke in the right side, were more than twice as likely to have good outcomes at three months and to survive three months after tPA. "Other studies have shown that people with strokes in the left side of the brain have a better recovery than people with strokes on the right side of the brain, but this is the first time this has been shown in people who received tPA," said Elkind.
Elkind says that women should still seek immediate treatment for any signs of stroke. "Women are definite candidates for treatment with tPA, which is still our only approved medical treatment for acute ischemic stroke. It cannot be overemphasized enough that these are secondary findings from a study done for other purposes. More research is needed to confirm these findings, and to determine why women may not respond as well as men to the treatment."
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