{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:52:59Z","timestamp":1791355979791,"version":"4.3.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Whether adjunct intra\u2010arterial urokinase has differential effectiveness and safety by sex among patients with acute ischemic stroke who achieve near\u2010complete to complete reperfusion after endovascular thrombectomy (EVT) remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This post hoc analysis of the POST\u2010UK (Adjunctive Intra\u2010Arterial Urokinase After Successful Endovascular Thrombectomy in Patients With Large\u2010Vessel Occlusion Stroke) multicenter randomized clinical trial included 534 patients with proximal intracranial large\u2010vessel occlusion who achieved near\u2010complete to complete reperfusion after endovascular thrombectomy. Participants were assigned to intra\u2010arterial urokinase or no adjunct intra\u2010arterial thrombolysis. The primary effectiveness outcome was 90\u2010day survival without disability, defined as a modified Rankin Scale score of 0 to 1. Primary safety outcomes were 90\u2010day all\u2010cause death and symptomatic intracranial hemorrhage within 48 hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 534 participants, 223 were female and 311 were male. The treatment\u2010by\u2010sex interaction for the primary outcome was not statistically significant (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      for interaction=0.06). In sex\u2010stratified analyses, intra\u2010arterial urokinase showed a potential benefit signal for 90\u2010day survival without disability among female participants (46.7% versus 32.2%; adjusted risk ratio [RR], 1.47 [95% CI, 1.07\u20132.02];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.02), whereas no statistically significant difference was observed among male participants (44.1% versus 46.6%; adjusted RR, 0.97 [95% CI, 0.77\u20131.22];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.79). No statistically significant differences in safety outcomes were observed between treatment groups in either sex, including 90\u2010day mortality and symptomatic intracranial hemorrhage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Adjunct intra\u2010arterial urokinase after endovascular thrombectomy showed a potential benefit signal for 90\u2010day disability\u2010free survival among female participants, without statistically significant differences in male participants or hemorrhagic outcomes across sex subgroups. These findings should be considered hypothesis generating and warrant confirmation in future prospective studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\">www.chictr.org.cn<\/jats:ext-link>\n                      ; Unique Identifier: ChiCTR2200065617.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051642","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:25:36Z","timestamp":1788150336000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Differences in Treatment Effect of Adjunctive Intra\u2010Arterial Urokinase After Successful Thrombectomy: A Post Hoc Secondary Analysis of the POST\u2010UK Randomized Clinical Trial"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6759-1867","authenticated-orcid":false,"given":"Xuanyu","family":"Chen","sequence":"first","affiliation":[{"name":"Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University)","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8419-0133","authenticated-orcid":false,"given":"Linyu","family":"Li","sequence":"additional","affiliation":[{"name":"Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University)","place":["Chongqing, China"]},{"name":"The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4068-3139","authenticated-orcid":false,"given":"Gaoming","family":"Li","sequence":"additional","affiliation":[{"name":"Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University)","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7958-9859","authenticated-orcid":false,"given":"Lingyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Second Hospital of Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4060-3935","authenticated-orcid":false,"given":"Haoxuan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University)","place":["Chongqing, 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