Gender Differences in Etiology and Outcomes of Acute Ischemic Stroke: A Study from Armenia’s Largest Comprehensive Stroke Center

ABSTRACT

Background: The impact of gender on acute ischemic strokes (AIS) is increasingly getting recognized.

Aim: To analyze the gender-related differences in etiology and outcome of AIS in a biggest comprehensive stroke center in Armenia.

Methods: The study included all consecutive patients with AIS who suffered it between September 2023 and September 2024 from the prospective registry of the Comprehensive Stroke Center of Erebouni Medical Center in Yerevan, Armenia. The stroke severity was assessed using National Institutes of Health Stroke Scale (NIHSS), and etiological classification was done using TOAST (Trial of ORG 10172 in Acute Stroke Treatment). The functional outcome was evaluated by modified Rankin Score (mRS).

Results: A total of 1,034 patients were included, of whom 519 (39.8%) were females. Women were statistically older than men, with a mean age of 73±10.7 years vs. 68±10.8 years in men (p=0.0001). Females had a higher admission NIHSS compared to males (7.55±6.4 vs. 6.77± 5.9, p=0.04). Furthermore, the incidence of cardioembolic strokes was higher in females than in males (198/519; 38.2% vs. 208/785; 26.5%, p=0.0001). Atherosclerotic stroke was more common in men (97/785; 12.4% vs. 43/519; 8.3%, p=0.02), whereas lacunar strokes were equally distributed (194/785; 24.7% vs. 109/519; 21%, p=0.15). However, the rate of reperfusion therapies, the proportion of functionally independent patients (mRS 0-2) at discharge, and in-hospital mortality did not differ significantly between women and men: 51.1% vs. 57.1% (p=0.1), 25.0% vs. 21.3% (p=0.1), and 13.1% vs. 11.7% (p=0.4), respectively.

Conclusion: Our data, obtained from at the largest comprehensive stroke unit in Armenia, suggest some gender differences in stroke etiology, but access to reperfusion therapy and stroke outcomes were virtually identical for both genders.