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To the Editor:
In their recently published study, Deng et al.1 report that almost twice as many men than women received tissue plasminogen activator (tPA) for acute ischemic stroke (AIS, male:female ratio of 1.87). The authors state that the reasons for this are unclear but refer to a study that found that emergency physicians saw men with AIS faster than women even when stroke severity and type were controlled.2
In our facility, we observed that among all tPA treated patients with AIS over a 9-year period (May 1996 to May 2005, n = 152), the male to female ratio was 1.76. This ratio was 1.06 for patients with AIS who presented within 3 hours of symptom onset (i.e., those potentially eligible for tPA treatment, n = 805, p < 0.01, chi-square test). Compared with men, the women from this group had higher median stroke severity scores (7 [interquartile range 6 to 9] vs …
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