TY - JOUR
T1 - Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19
AU - Cerebral Venous Sinus Thrombosis With Thrombocytopenia Syndrome Study Group
AU - Scutelnic, Adrian
AU - van de Munckhof, Anita
AU - Krzywicka, Katarzyna
AU - van Kammen, Mayte Sánchez
AU - Lindgren, Erik
AU - Cordonnier, Charlotte
AU - Kleinig, Timothy J
AU - Field, Thalia S
AU - Poli, Sven
AU - Lemmens, Robin
AU - Middeldorp, Saskia
AU - Aaron, Sanjith
AU - Borhani-Haghighi, Afshin
AU - Arauz, Antonio
AU - Kremer Hovinga, Johanna A
AU - Günther, Albrecht
AU - Putaala, Jukka
AU - Wasay, Mohammad
AU - Conforto, Adriana Bastos
AU - de Sousa, Diana Aguiar
AU - Jood, Katarina
AU - Tatlisumak, Turgut
AU - Ferro, José M
AU - Coutinho, Jonathan M
AU - Arnold, Marcel
AU - Heldner, Mirjam R
N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by The Netherlands Organisation for Health Research and Development (ZonMw, grant number 10430072110005), the Dr. C.J. Vaillant Foundation, and Hospital District of Helsinki and Uusimaa (grant TYH2022223). Publisher Copyright: © European Stroke Organisation 2023.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - INTRODUCTION: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men.PATIENTS AND METHODS: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men.RESULTS: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28-54) vs 45 (28-56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28-79) vs 68 (30-125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19-62) vs 53 (20-92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ.DISCUSSION AND CONCLUSIONS: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.
AB - INTRODUCTION: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men.PATIENTS AND METHODS: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men.RESULTS: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28-54) vs 45 (28-56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28-79) vs 68 (30-125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19-62) vs 53 (20-92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ.DISCUSSION AND CONCLUSIONS: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.
KW - CVST
KW - VITT
KW - sex differences
UR - http://www.scopus.com/inward/record.url?scp=85178498350&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/23969873231185213
DO - https://doi.org/10.1177/23969873231185213
M3 - Article
C2 - 37434312
SN - 2396-9873
VL - 8
SP - 1001
EP - 1010
JO - European Stroke Journal
JF - European Stroke Journal
IS - 4
ER -