More pronounced effect of metabolic syndrome on resistance to intravenous thrombolysis for acute ischaemic stroke in women than in men
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The presence of a metabolic syndrome may doubly impact on stroke risk in women, by both increasing its occurrence and by conferring resistance to thrombolysis. This study was designed to examine whether there might be gender differences in the impact of metabolic syndrome on the response to intravenous thrombolysis for acute middle cerebral artery (MCA) ischaemic stroke. A total of 125 consecutive ischaemic stroke patients, treated with intravenous tissue-type plasminogen activator according to SITS-MOST criteria, with an MCA occlusion on prebolus transcranial Doppler examination, were prospectively studied. Metabolic syndrome was diagnosed according to the American Heart Association/National Heart, Lung, and Blood Institute 2005 criteria. Multivariate-adjusted, logistic-regression analyses revealed that metabolic syndrome was associated with resistance to tissue-type plasminogen activator, independently of other baseline variables and of individual metabolic syndrome components. Moreover, metabolic syndrome was associated with a significantly higher odds of resistance to thrombolysis in women than in men. In conclusion, the effect of metabolic syndrome on resistance to intravenous thrombolysis for acute MCA ischaemic stroke appears to be more marked in women than in men.
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