Disparity in outcomes reported for women, black stroke survivors
Roth D. Stroke. 2011; doi:10.1161/STROKEAHA.110.595322.
Among incident stroke survivors with family caregivers, women and blacks were at heightened risk for poor outcomes at 1 year after a first-time stroke event vs. men and white survivors, according to new data published in Stroke.
The study participants included 112 survivors of incident stroke from the national Reasons for Geographic and Racial Differences in Stroke (REGARDS) project. The survivors were community-dwelling residents from 28 states who had family caregivers and incident stroke events between Nov. 15, 2004, and Sept. 10, 2009.
Study data revealed a significantly higher percentage of white stroke survivors living with their family caregiver than black survivors (76% vs. 43%; P=.0003). After controlling for age, education and whether the stroke survivors lived with their primary family caregivers, researchers reported that blacks had worse outcomes than whites, and women had worse outcomes than men (P<.05 for both race and gender effects).
“Our results show that previously found race and gender differences in long-term stroke outcome are apparent, even when studied in a prospective population-based sample, and even when a family caregiver is available to all participants,” the researchers wrote. “Future research should more closely examine the mechanisms behind these differences, including more detailed assessments of the involvement of family caregivers and other cultural and demographic factors that may affect service utilization and recovery from stroke.”
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Two-year data promising for drug-eluting stent
Dake M. Presented at: 2011 International Symposium on Endovascular Therapy; Jan. 16-20; Miami Beach.
Patients treated with a drug-eluting stent had improved patency rate at 2 years, as well as patient safety, when compared with percutaneous transluminal angioplasty, according to data from a prospective, randomized trial.
The study, which was recently presented at the International Symposium on Endovascular Therapy, included 479 patients who were treated with either a paclitaxel-coated drug-eluting stent (Zilver PTX, Cook Medical; n=241) or percutaneous transluminal angioplasty (n=238). Among the risk factors patients presented with included hypertension (drug-eluting stent, 89% vs. percutaneous transluminal angioplasty, 82%), high cholesterol (drug-eluting stent, 76% vs. percutaneous transluminal angioplasty, 70%) and diabetes (drug-eluting stent, 49% vs. percutaneous transluminal angioplasty, 42%).
At 2 years, event-free survival was 86.6% in the drug-eluting stent group vs. 77.6% in the percutaneous transluminal angioplasty arm (P<.01). Primary patency was significantly improved in the drug-eluting stent arm (74.8% vs. 51.8%; P<.01), as was provisional patency (81.2% vs. 62.7%; P<.01). Researchers also reported that the drug-eluting stent reduced 24-month restenosis rates by 50% (37.3% vs. 18.8%).
“This 24-month data is important because it shows not only sustained effect of the drug-eluting platform, but an actual widening of the reductions between the drug-eluting stent and the bare metal stent,” Michael D. Dake, MD, with the department of cardiothoracic surgery at Stanford University School of Medicine and researcher on the study, told Cardiology Today.
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