Evidence map›Paper›PMID 36349887›Full record

Trial reportEuropean journal of neurology2023

Sex differences in imaging and clinical characteristics of patients from the WAKE-UP trial.

Anke Wouters, Lauranne Scheldeman, Hannelore Liessens, Patrick Dupont, Florent Boutitie, Bastian Cheng, Martin Ebinger, Matthias Endres, Jochen B Fiebach, Christian Gerloff and 7 more

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in European journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 36% 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

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Trial
  2. Article
  3. 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

17 authors at 12 institutions in 8 countries.

Anke WoutersNeurology, Amsterdam University Medical Centers location AMC, Amsterdam, the Netherlands.ORCID 0000-0001-5229-2699
Lauranne ScheldemanDepartment of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.ORCID 0000-0002-5263-3550
Hannelore LiessensDepartment of Neurology, University Hospitals Leuven, Leuven, Belgium.
Patrick DupontDepartment of Neurosciences, Laboratory for Cognitive Neurology, KU Leuven - University of Leuven, Leuven, Belgium.
Florent BoutitieHospices Civils de Lyon, Service de Biostatistique, Université Lyon, Lyon, France.
Bastian ChengKlinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Martin EbingerCenter for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.
Matthias EndresCenter for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.
Jochen B FiebachCenter for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.
Christian GerloffKlinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Keith W MuirInstitute of Neuroscience & Psychology, University of Glasgow, Glasgow, UK.ORCID 0000-0001-9535-022X
Norbert NighoghossianDepartment of Stroke Medicine, Université Claude Bernard Lyon 1; Hospices Civils de Lyon, Lyon, France.ORCID 0000-0003-0594-4409
Salvador PedrazaDepartment of Radiology, Institut de Diagnostic per la Image (IDI), Hospital Dr Josep Trueta, Institut d'Investigació Biomedica de Girona (IDIBGI), Parc Hospitalari Marti i Julia de Salt - Edifici M2, Girona, Spain.
Claus Z SimonsenDepartment of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Vincent ThijsStroke Theme, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.
Götz ThomallaKlinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Robin LemmensDepartment of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.
University Medical Center Hamburg-Eppendorf · DEVIB-KU Leuven Center for Brain & Disease Research · BEUniversité Claude Bernard Lyon 1 · FRAarhus University Hospital · DKAmsterdam University Medical Centers · NLCharité - Universitätsmedizin Berlin · DEGerman Center for Neurodegenerative Diseases · DEHumboldt-Universität zu Berlin · DEInstitut d'Investigació Biomèdica de Girona · ESKU Leuven · BEThe University of Melbourne · AUUniversity of Glasgow · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeSex-based differences in acute ischemic stroke are a well-known phenomenon. We aimed to explore these differences between women and men in the Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke (WAKE-UP) trial.

methodsWe compared baseline demographic and imaging characteristics (visual fluid-attenuated inversion recovery [FLAIR] positivity, relative FLAIR signal intensity, collateral status) between women and men in all screened patients. In randomized patients (i.e., those with diffusion-weighted imaging (DWI)-FLAIR mismatch), we evaluated a modifying role of sex on the treatment effect of alteplase in multivariable logistic regression, with treatment adjusted for National Institute of Health Stroke Scale (NIHSS) score and age. Dependent variables were modified Rankin Scale (mRS) score of 0-1 at 90 days and distribution of mRS scores at 90 days.

resultsOf 1362 screened patients, 529 (38.8%) were women. Women were older than men, had higher baseline NIHSS scores and smoked less frequently. FLAIR positivity of the DWI lesion was equally present in women (174/529, 33.1%) and men (273/833, 33.3%; p = 1.00) and other imaging variables also did not differ between the sexes. In a total of 503 randomized patients, of whom 178 were women (35.4%), sex did not modify the treatment effect of alteplase on mRS score 0-1 or on the total distribution of mRS scores.

conclusionAs in many other stroke trials, more men than women were included in the WAKE-UP trial, but the presence of a visual DWI-FLAIR mismatch and the relative FLAIR signal intensity did not differ between the sexes. The treatment effect of alteplase was not modified by sex.

Indexed as

Brain IschemiaIschemic StrokeStrokeDiffusion Magnetic Resonance ImagingFemaleHumansMaleSex CharacteristicsThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTissue Plasminogen Activatorischemic strokeMRIsexwake-up

Identifiers

PMID36349887
PMCPMC10099623
OpenAlexW4308635001

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.