Sex-Related Differences in Endovascular Treatment Outcomes for Acute Large Infarcts: The ANGEL-ASPECT Subanalysis
作者：Dapeng Sun, Xin Guo, Ling Li, Liwen Jiao, Thanh N. Nguyen, Mohamad 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, Xiaohui Chen, 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 Yang · 发表于：Stroke · 年份：2025 · DOI：10.1161/strokeaha.124.050025 · 被引用次数：4 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Intracerebral and Subarachnoid Hemorrhage Research
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 no...