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Women Benefit Less From Clot-Busting Stroke Drug
But the finding is no reason to change how doctors use tPA, experts say
By Ed Edelson
HealthDay Reporter
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TUESDAY, March 13 (HealthDay News) -- Women who suffer strokes are much less likely than men to benefit from treatment with the powerful clot-dissolving drug known as tissue plasminogen activator (tPA), new research suggests.
The biggest such study yet conducted found that while more women survived their stroke after receiving tPA, male patients were more than three times as likely to retain good physical function as measured by a test three months after tPA treatment.
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"The most intriguing possibility is that there might be an intrinsic biological difference in the way in which women respond to tPA vs. how men respond to tPA," said Dr. Gary Abrams, an associate professor of neurology at the University of California, San Francisco, and a spokesman for the American Academy of Neurology.
Abrams was not involved in the study, which is published in the March 13 issue of Neurology.
Federal rules mandate that tPA can be used only if treatment starts in the first three hours after a stroke. The drug helps limit brain damage by dissolving clots that block blood flow through arteries.
The trial included almost 1,400 stroke patients, 333 of whom (24 percent) were treated with tPA within three hours.
The study found that 47.5 percent of men getting tPA had good function three months later on a standard measure called the Barthel Index, compared to 30.3 percent of women. On another measure, the Rankin Score, 32.2 percent of men and 23.4 percent of women did well.
"In general, women have worse outcomes than men after a stroke," noted lead researcher Dr. Mitchell S. V. Elkind, an associate professor of neurology at Columbia University, in New York City. "There are potential biological reasons why women may not respond as well as men to tPA. Hormonal factors such as the effects of hormones on blood clots may be the reason."
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Copyright © 2007 ScoutNews, LLC. All rights reserved.
Last updated 3/13/2007
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SOURCES: Gary Abrams, M.D., associate professor, neurology, University of California, San Francisco, director, Neurorehabilitation Clinic, UCSF Medical Center, and spokesman, American Academy of Neurology; Mitchell S. V. Elkind, M.D., associate professor of neurology, Columbia University, New York City; Edgar J. Kenton III, M.D., chair, American Academy of Neurology practice committee; March 13, 2007, Neurology
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