| Summary: | Background: Ischemic stroke is an important cause of death and disability. However, data about gender-differences in stroke are controversial.
Methods: In the nationwide sample, male and female inpatients were selected by screening for ischemic stroke by ICD-Code(I63) and compared. In a second study, we performed a retrospective analysis of patients who underwent transesophageal echocardiography (TEE) and screened for gender specific associations between clinical and echocardiographic parameters and atrial thrombi formation.
Results: Males had a higher incidence of ischemic stroke than females (372 vs. 340 per 100,000 citizens) with a substantial age-depending increase. Percentage of stroke patients with atrial fibrillation/flutter (AF, 34.2% vs. 26.5%) and the case-fatality rate (9.4% vs. 7.1%) were higher in females. AF seems to aggravate stroke events. In the retrospective study, 227 patients were enrolled (87 females (38.3%)). Females were older (IQR 72.0 (72.0–79.0) vs. 66.5 (57.3–76.8) years, P = 0.013), showed smaller right atrial (RA) area and slower blood flow velocity in left atrial appendage (LAA) (41.2 (29.2–58.5) vs. 50.0 (34.3–67.1) cm*sec−1, P = 0.038). Promoting factors of atrial thrombi in both genders were lower blood-flow velocity in LAA, larger LAA diameters, higher CHA2DS2-VASc-score and heart failure. AF, larger atrial septal-lateral diameters and areas were associated with atrial thrombi especially in males.
Conclusions: Our study demonstrated gender-specific differences in ischemic stroke. Incidence of ischemic stroke was higher in males than in females increasing exponentially with growing age in both genders. Females had a higher case-fatality rate presumably due to higher rate of AF. Promoting factors of atrial thrombi differ especially regarding atrial volumes and blood flow velocity in the LAA.
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