Sex differences in lipid-lowering therapy after atherothrombotic ischemic stroke: The multicenter MaLIC study.

Authors

Carolina Guerrero Buitrago, Dídac Llop Paredes, Oscar Mascaró Cavaller, Marta Mauri Pont, Rosa Borrallo Almansa, Àngels Pedragosa Vall, en representación de los investigadores del estudio MaLIC

Published in

Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis. Pages 500966. Oct 19, 2026. Epub Oct 19, 2026.

Abstract

Women have poorer outcomes after ischaemic stroke. The primary objective was to assess sex-based differences in the management and intensity of lipid-lowering therapy following non-cardioembolic ischaemic stroke or transient ischaemic attack (TIA). Secondary objectives were to analyse sex-based differences in vascular risk profile, pre-event functional status, and stroke severity.
Subanalysis of the second phase of the MaLIC study (Management of Stroke in Catalonia and the Balearic Islands), a prospective, multicentre study conducted in 20 hospitals. Adults with non-cardioembolic ischaemic stroke or TIA were included. Vascular risk factors, stroke severity, lipid profile, and intensity of lipid-lowering therapy at hospital discharge were compared according to sex.
A total of 591 patients were included, of whom 223 (37.7%) were women. Women were older (76 vs. 70 years; P<.0001), had greater pre-event functional dependence (mRS>2: 16.1% vs. 7.9%; P=.003), and a lower prevalence of ischaemic heart disease (4.9% vs. 14.4%; P<0001) and peripheral arterial disease (6.3% vs. 13.0%; P=.01). Although women had higher LDL cholesterol levels at admission (103.5 vs. 92mg/dl; P=.004), they were less frequently prescribed high-intensity lipid-lowering therapy at discharge (64.1% vs. 72.3%; P=.04). No differences were observed in stroke code activation or reperfusion therapies.
Women were less frequently prescribed high-intensity lipid-lowering therapy at discharge than men, despite having higher LDL cholesterol levels. These findings highlight an opportunity to optimise lipid-lowering therapy after the cerebrovascular event.

PMID:
42897011
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.

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