Evidence map›Paper›PMID 36241125›Full record

ArticleJournal of vascular surgery2023

Females are less likely to receive best medical therapy for stroke prevention before and after carotid revascularization than males.

Sanuja Bose, David P Stonko, Georgina M Pappas, Laura M Drudi, Michael C Stoner, Caitlin W Hicks

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of vascular surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 14 citations in OpenAlex.

  1. Observational
  2. Article
  3. Article
  4. Article
  5. Article
  6. Sex Differences in the Evaluation and Treatment of Stroke.Handbook of experimental pharmacology · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Sanuja BoseDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
David P StonkoDepartment of Surgery, The Johns Hopkins Hospital, Baltimore, MD.
Georgina M PappasDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
Laura M DrudiDivision of Vascular Surgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada.
Michael C StonerDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
Caitlin W HicksDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: chicks11@jhmi.edu.
Johns Hopkins University · USUniversity of Rochester Medical Center · USCentre Hospitalier de l’Université de Montréal · CAJohns Hopkins Hospital · US

Funding

Risk Factors and Outcomes Associated with Late-Life Diabetic Peripheral NeuropathyK23DK124515 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI HICKS, CAITLIN WHITNEY · 2020 to 2024
$898k
NIDDK NIH HHS K23 DK124515
6 · The paper itself

Abstract

backgroundCurrent professional guidelines recommend best medical therapy (BMT) with statin agents and antiplatelet therapy for primary and secondary stroke prevention in patients with carotid artery stenosis. We aimed to assess the association of patient sex with preoperative BMT in patients undergoing carotid revascularization.

methodsWe performed a retrospective review of Vascular Quality Initiative patients who underwent carotid endarterectomy or carotid artery stenting between January 2003 and February 2022. Multivariable logistic regression models were used to assess the association of patient sex with preoperative BMT after adjusting for sociodemographic, comorbidity, and disease severity characteristics. In-hospital outcomes were assessed by sex and preoperative BMT status.

resultsOf 214,008 patients who underwent carotid revascularization, 38.7% (n = 82,855) were female and 61.3% (n = 131,153) were male. Overall, 77.2% (n = 63,922) of females were on preoperative BMT, compared with 80.4% (n = 105,375) of males (P < .001). After adjusting for baseline differences, females had 11% lower odds of being on BMT compared with males (adjusted odds ratio, 0.89; 95% confidence interval, 0.86-0.91). Postoperatively, females had 18% lower odds of being prescribed BMT than males (adjusted odds ratio, 0.82; 95% confidence interval, 0.79-0.84). In-hospital stroke (1.20% vs 1.51%), death (0.37% vs 0.66%), and stroke/death (1.46% vs 1.98%) were all significantly lower for patients on BMT (all P < .001).

conclusionsThere is a significant discrepancy in the proportion of females versus males receiving preoperative BMT for stroke prevention before carotid artery revascularization. In-hospital outcomes are worse in patients without BMT, highlighting the importance of raising awareness and implementing targeted interventions to improve preoperative adherence to stroke prevention guidelines.

Indexed as

Carotid StenosisEndarterectomy, CarotidStrokeCarotid ArteriesFemaleHumansMaleRetrospective StudiesRisk AssessmentRisk FactorsStentsTreatment OutcomeBest medical therapyCarotid artery stenosisMedical managementStroke guidelinesStroke prevention

Identifiers

PMID36241125
PMCPMC9974567
OpenAlexW4304689988

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.