Long-term mortality and thrombolysis therapy after a first acute ischemic stroke: gender differences. Ebrictus II Study. Authors & Affiliations Clua-Espuny JL 1 ; González-Henares MªA 2 ; López-Pablo, C 3 ; Queralt-Tomas Mª Ll 4 ; Ripolles-Vicente R 1 ; Panisello-Tafalla A 2 ; Lucas-Noll J 5 ; Calduch-Noll C 6 on Behalf of Ebrictus Group Investigators Primary Care. Institut Català Salut. EAP Tortosa 1-est. Spain. 2. Primary Care. Institut Català Salut. EAP Aldea- Camarles-Ampolla. Spain. 3. USR Terres de l’Ebre, IDIAP Jordi Gol-IISPV-Fundació Dr. Ferran, Spain 4. Primary Care. Institut Català Salut. EAP Tortosa est. Spain. 5. Primary Care. Institut Català Salut. EAP Deltebre. Spain. 6. Primary Care. Institut Català Salut. UUDD Tortosa. Spain. Rationale A number of large trials have confirmed the benefits of thrombolysis in acute stroke, but there are gender differences in stroke. Methods & Results Ebrictus Project is a study based on a cohort population from incident cases on the first stroke episode (included TIA) from 01/04/2006 to 31/12/2013 participated by Primary care and neurological service referent. Statistical approaches for analyzing survival outcomes and their relation with thrombolysis therapy. A total of 1337 first-ever strokes were included (614 in women). Mean age 74.06±11.9 years (25-90), higher percentage (p 0.004) women than men (54.1%), and significant differences (p <0.001) in the mean age men (72.34±11.9) and females (76.09±11.7) and significantly older (p <0.001) than those in the thrombolysis (68.8±12.0 ). The mean follow-up was 3.12±2.51 years. The average disease duration is 6.67 years. At 90 days was similar in men and women produced 34.8% of deaths and at five years an 44.9%(ICI95% ). No differences in adjusted mortality rates between sexes (Fig. 1). The incidence rate ratio by sex is (IC95% ). Cumulative probability of overall survival is 0.92±0.08 the first month, 0.77±0.01 in the first year and 0.52±0.01 at five years. The mortality curves among the ischemic with or without thrombolysis are significantly (p <0.003) different (Fig. 2). The Incidence Ratio is 0.57 (CI95% ). The reduc- tion RRR is 39.8% and ARR 18%, and the NNT 5 to prevent one death. Were identified as protective factors of mortality: the realization of thrombolysis (CI95% p 0.002), and Barthel ≥ 60 (CI95% p 0.002) score. 98 (8.6%) patients (48 in women) received thrombolysis. The difference in the number of deaths by gender increases so that at end of period survival is significantly lower in women (Fig. 3). The probability of survival at end of study among women was 0.75±0.06 and 0.54±0.09 men, a statistically significant difference (p 0.012) and showed an increased risk in men compared to women IR = 3.2 (IC95% ), we can indicate that exposure to thrombolysis in women is much more protective than men. Conclusion stroke death rates were lower in women after thrombolysis treatment and suggest significant benefit for women in this setting. Clinical Relevance It still remains to be determined whether is true gender difference in response to thrombolysis treatment. The challenge is whether these data can achieve better health outcomes through the selection of patients with a more favorable risk versus thrombolytic profile. Key words: Stroke. Thrombolysis. Community based study. Mortality. Survival.