Gender difference in prognosis after transient cerebral ischemia or minor stroke

The objective of this study was to determine if prognosis after transient cerebral ischemia or minor stroke is different for women and men. Eligible patients (n = 142), identified on a carotid ultrasound roster, had been hospitalized between 1984 and 1987 within 30 days of a first carotid transient ischemic attack or minor stroke. Participants were considered to have a study outcome if they had a stroke or died within 2 years. Gender differences were measured with crude and directly standardized relative risks for women compared with men. The crude 2-year risk of stroke or death was 35% for women and 20% for men. The crude relative risk for women compared with men was 1.74 (95% confidence interval = 1.01-3.00). The relative risk standardized for age was 1.39 (95% confidence interval = 0.84-2.29). The relative risk standardized for prognostic strata and comorbid illness was 1.38 (95% confidence interval = 0.75-2.53). This study does not confirm the hypothesis of a gender difference for risk of stroke or death after an initial transient ischemic attack or minor stroke. Although the crude relative risk for women was large and significant, the adjusted relative risk was smaller and nonsignificant. The effect of gender needs to be examined in a larger study that has adequate power to detect an important difference between men and women at an acceptable level of statistical significance.