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Sex differences in the Norwegian Tenecteplase Trial (NOR-TEST)
Håkon Ihle-Hansen1, Else Charlotte Sandset2,3, Hege Ihle-Hansen1,2
1Department of Medicine, Baerum Hospital, Vestre Viken Hospital Trust, Drammen, Norway.
European Journal of Neurology
|September 26, 2021
Summary
This study found women had less cardiovascular risk but more severe strokes in the NOR-TEST trial. Despite differences in baseline characteristics, clinical outcomes after acute ischemic stroke treatment were similar between sexes.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Precision Medicine
Background:
- Sex differences in acute ischemic stroke are gaining attention in precision medicine.
- The Norwegian Tenecteplase trial (NOR-TEST) provides data to explore these disparities.
Purpose of the Study:
- To investigate sex disparities in baseline characteristics, management, and outcomes of acute ischemic stroke patients treated with intravenous thrombolysis.
- To compare tenecteplase with alteplase treatment across sexes within the NOR-TEST trial.
Main Methods:
- Analysis of 1100 patients from the NOR-TEST trial (2012-2016).
- Comparison of sex differences using multivariable logistic regression.
- Evaluation of treatment heterogeneity via interaction terms.
Main Results:
- Women (40%) were underrepresented, especially in older age groups (>80 years).
- Women had lower cardiovascular risk factors (e.g., diabetes) and higher HDL cholesterol.
- Despite similar treatment times, women presented with more severe strokes (higher NIHSS) and more stroke mimics.
Conclusions:
- Women were underrepresented in the NOR-TEST trial.
- Included women exhibited lower cardiovascular risk but presented with more severe strokes.
- No significant sex differences were observed in clinical outcomes, including mortality and functional status.
