Sex Differences in Stroke Evaluations in the Ischemic Stroke Genetics Study

Leslie-Mazwi, Thabele M.; Brott, Thomas G.; Brown, Robert D.; Worrall, Bradford B.; Silliman, Scott L.; Case, L. Douglas; Frankel, Michael R.; Rich, Stephen S.; Meschia, James F.

doi:10.1016/j.jstrokecerebrovasdis.2007.03.004

« Previous Next »Journal of Stroke & Cerebrovascular Diseases
Volume 16, Issue 5 , Pages 187-193, September 2007

Sex Differences in Stroke Evaluations in the Ischemic Stroke Genetics Study

Presented at the 58th Annual Meeting of the American Academy of Neurology, San Diego, California, April 1–8, 2006.

Thabele M. Leslie-Mazwi, MD
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
Thomas G. Brott, MD
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
Robert D. Brown Jr, MD
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
Bradford B. Worrall, MD
- Department of Neurology, University of Virginia, Charlottesville
Scott L. Silliman, MD
- Department of Neurology, Shands Healthcare/University of Florida, Jacksonville
L. Douglas Case, PhD
- Division of Public Health Sciences, Wake Forest University School of Medicine, Salem, North Carolina
Michael R. Frankel, MD
- Department of Neurology, Emory University, Atlanta, Georgia.
Stephen S. Rich, PhD
- Division of Public Health Sciences, Wake Forest University School of Medicine, Salem, North Carolina
James F. Meschia, MD
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
- Address correspondence to James F. Meschia, MD, Department of Neurology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224.

Received 12 December 2006; accepted 14 March 2007.

Background: Epidemiologic studies suggest sex differences in evaluation of patients presenting with ischemic stroke. Sex differences in stroke evaluation could lead to sex differences in the validity of diagnosing ischemic stroke subtypes. This study assessed sex differences in the Ischemic Stroke Genetics Study (ISGS). Methods: The ISGS is a prospective case-control genetic association study of patients with first-ever ischemic stroke at 5 US tertiary stroke centers. The diagnostic tests performed as part of medical care were recorded for each enrolled patient. Results: A total of 505 patients were enrolled; 45% (229 of 505) were women and 55% (276 of 505) were men. Mean age at time of stroke was greater for women (66.6 v 61.9 years; P = .001). Frequency of brain computed tomography was 92% (254 of 276) for men and 90% (206 of 229) for women (P = .42). Magnetic resonance imaging was completed in 84% (232 of 276) of men and 83% (191 of 229) of women (P = .91). Frequency of electrocardiography was 91% (252 of 276) for men and 90% (206 of 229) for women (P = .60). Echocardiography was done in 74% (203 of 276) of men and 79% (180 of 229) of women (P = .19). Cervical arterial imaging occurred in 91% (208 of 229) of women and 86% (237 of 276) of men (P = .09). Intracranial vascular imaging was performed in 75% (207 of 276) of men and 79% (181 of 229) of women (P = .28). Conclusions: Our findings suggest no significant sex differences in the extent to which major diagnostic tests were performed in patients in ISGS. Dedicated tertiary stroke centers may reduce the sex bias in stroke evaluation that has been identified by previous studies.