Abstract T P66: Analysis of Tissue Plasminogen Activator (rt-PA) Eligibility by Gender in the Greater Cincinnati/Northern Kentucky Stroke Study
Background/Purpose: It is unknown whether eligibility for rt-PA differs by gender and whether this contributes to the gender differences in rt-PA administration present in some populations.
Methods: We included all ischemic stroke patients ≥18 years old among residents of the Greater Cincinnati/Northern Kentucky Stroke region (5 counties) who presented to emergency departments of the 17 area hospitals in 2005. Data regarding rt-PA exclusion as defined by the 2007 AHA Guidelines and ECASS III were abstracted by study nurses and reviewed by study physicians. Outcomes included rt-PA eligibility and exclusion criteria by gender. Data are reported as raw counts and weighted percentages. Chi-square tests and generalized linear models were used, as appropriate.
Results: Our sample included 1838 ischemic strokes; 57.9% were women, 24.3% were black. Mean age was 72.2 yrs for women and 66.1 yrs for men. Overall eligibility for rt-PA did not differ by gender (6.7% for men vs. 6.2% for women, p=.61), even after adjusting for age (7.0% vs. 6.0% p=.36). Exclusion criteria are listed in the table. Similar proportions of women and men arrived beyond 3 and 4.5 hours of symptom onset, but more women had SBP>185 or DBP>110, still significant after adjusting for age. In terms of ECASS III criteria, more women were over 80 years old and had NIHSS>25.
Conclusions: Within a large, biracial population, similar proportions of women and men with ischemic stroke were eligible for rt-PA. However, women were more likely be >80 years old and have NIHSS>25, suggesting that women may benefit less from the ECASS III criteria. Further research is needed to investigate gender differences in rt-PA exclusion criteria.
Author Disclosures: T.E. Madsen: None. J.C. Khoury: Research Grant; Significant; NS30678. K.A. Alwell: Research Grant; Significant; NS30678. C.J. Moomaw: Research Grant; Significant; NS30678. P. Khatri: Other Research Support; Significant; PRISMS STUDY. B.M. Kissela: Research Grant; Significant; NS30678. F. De Los Rios La Rosa: None. D. Woo: Research Grant; Modest; NS30678. O. Adeoye: Research Grant; Modest; NS30678. M.L. Flaherty: Research Grant; Modest; NS30678. S. Ferioli: Research Grant; Modest; NS30678. D.O. Kleindorfer: Research Grant; Significant; NS30678. Speakers' Bureau; Modest; Genentech.
- © 2014 by American Heart Association, Inc.