Women need clot-busting therapy after stroke

Anne Tremblay, a stroke patient with husband Don Bray and baby Anouk, and Dr. Michael Hill (far right) Photo credit: Bruce PerraultResearch from the University of Calgary’s Faculty of Medicine shows that women who don’t get the clot-busting drug tPA after a stroke fare worse than men who receive the same level of care. However, the study found that women and men respond equally well when the clot-busting therapy is administered. The study is published in the March 2, 2010, print issue of Neurology®, the medical journal of the American Academy of Neurology.

“Like men, women need to be treated for stroke as soon as possible,” says study author Dr. Michael Hill, a member of the Hotchkiss Brain Institute (HBI) and Director of the Stroke Unit at Foothills Hospital, Alberta Health Services. “We found that women who weren’t treated with the drug were 12-per-cent less likely than men to have a good outcome.”

“There could be many reasons why women who weren’t treated with the clot-busting drug fared worse than men, including biological reasons,” says Dr. Hill. “One social reason may be that more than 30 per cent of women were widowed compared to seven per cent of men at the time of stroke, and therefore did not have a spouse who could act as a caregiver. Also, post-stroke depression is more common in women than in men, which slows down recovery.”

Anne Tremblay knows how difficult it can be to recover from a stroke. The 34-year-old suffered a stroke last fall, going to hospital in an ambulance and leaving her three-month-old daughter and husband at home. “This study is very important. I was not pre-disposed to having a stroke. It was a very scary time for my family. My whole family could have collapsed. I hope this research helps more people recover.”

Scientists examined the Registry of the Canadian Stroke Network data of more than 2,000 stroke patients. Of those, 232 were treated with tPA and 44 per cent were women. After six months, former stroke patients were interviewed by phone about their ability to function and quality of life.
The study is consistent with previous research which increased the validity of the effect.

“This study highlights the interaction between our health and our social environment,” says Dr. Antoine Hakim, CEO and Scientific Director of the Canadian Stroke Network. “Women recover less well from stroke because they don’t have the same access to care providers. It is important that women can access tPA so they leave hospital with minimal deficits from stroke.”

The study was supported by the Canadian Stroke Network, a Network of Centres of Excellence (NCE), and the Ontario Ministry of Health and Long-Term Care.