Diferenças de Género no Tratamento de Fase Aguda do Acidente Vascular Cerebral Isquémico
DOI:
https://doi.org/10.24950/O/34/20/3/2020Palavras-chave:
Acidente Vascular Cerebral/tratamento farmacológico, Factores Sexuais, Isquemia Cerebral/tratamento farmacológicoResumo
Introdução: Na abordagem personalizada do acidente vascular cerebral (AVC) é importante definir se existem diferenças de género relativamente às caraterísticas clínicas, tratamento de fase aguda e resultados.
Material e Métodos: Estudo longitudinal retrospetivo que incluiu doentes com AVC isquémico admitidos na Unidade Cerebro Vascular, durante 30 meses, tratados com trombectomia com ou sem trombólise prévia, com o objetivo de avaliar diferenças de género.
Resultados: De 594 doentes, 50% eram mulheres apresentando, à admissão, idade mediana maior (78 vs 73 anos), maior pontuação na escala modificada de Rankin (mRS) e na National Institutes of Health Stroke Scale (NIHSS). Não houve diferenças no tipo de tratamento, no tempo mediano entre o início dos sintomas e tomografia computadorizada (TC), entre o tempo TC-trombólise ou na eficácia da revascularização. A disabilidade expressa pelo valor de mRS e a mortalidade aos 3 meses foram sobreponíveis entre géneros. Mais mulheres sofriam de fibrilhação auricular (FA) (51% vs 35%), no entanto menos mulheres com FA conhecida recebiam terapêutica anticoagulante antes do evento, comparativamente aos homens (38% vs 52%).
Discussão: Apesar das mulheres apresentarem idade mais elevada e maior grau de dependência, não existiram diferenças de género na eficácia do tratamento de fase aguda nem nos resultados a médio prazo.
Conclusão: No género feminino, a idade não deve constituir uma limitação à realização de terapêutica de fase aguda do AVC.
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