ABSTRACT NUMBER: ESOC2026YS250 SEX DIFFERENCES IN ISCHEMIC STROKE FOR TYPE 2 DIABETIC PATIENTS: A RETROSPECTIVE ANALYSIS OF RECURRENCE AND SURVIVAL

Abstract Background Recent meta-analyses indicate that women with Type 2 diabetes have increased risk of ischemic stroke compared to men. However, our understanding of sex-specific differences in recurrent ischemic stroke risk and survival in this population is limited. Methods A retrospective observational analysis at a tertiary-care hospital system was conducted between December 2013 – December 2023 to identify sex-specific associations between clinical parameters and recurrent ischemic stroke risk and survival in Type 2 diabetic patients. Multivariate logistic regression and Kaplan-Meier analysis were performed to predict recurrence risk and survival outcomes. Results We identified 5,226 Type 2 diabetic patients with acute ischemic stroke, with 690 cases of recurrent ischemic stroke. Patient sex was not independently associated with recurrence risk or 90-day mortality. Sex-specific models indicated that thrombolytic administration was associated with increased likelihood of 90-day mortality following first stroke for female patients only (OR: 1.72, 95% CI: 1.06 – 2.76, p = 0.03). There were no significant differences in regression model performance in prediction of recurrent ischemic stroke among the general and sex-specific models based on receiver operating curves (0.70 ≤ AUC ≤ 0.80). Thrombolytic administration was significantly associated with time to recurrence for male (HR: 0.47, 95% CI: 0.24 – 0.93), but not female patients. Diabetic males who received a thrombolytic at first ischemic stroke had significantly longer time to recurrence compared to diabetic female patients receiving thrombolysis (p = 0.049). Conclusion Our findings provide evidence of sex-specific differences in time to recurrent ischemic stroke based on thrombolytic administration and patient age. Conflict of interest Thilan Tudor: This research was funded through a FOCUS Medical Student Fellowship in Women's Health supported by the Edna G. Kynett Memorial Foundation. Manasa Kadiyala: nothing to disclose.