Safety and effectiveness of intravenous thrombolysis with recombinant tissue plasminogen activator in eighty years and older acute ischemic stroke patients

Y. Chen, C.-H. LI, Y.-X. Wang, C.-H. Zhang, Z. Dong, F.-F. Zhang, J.-H. Wang, P.-L. Zhang

Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin, China. peilanzhng@sina.com

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• Neurology

OBJECTIVE: To explore the safety and efficacy of intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) in elderly (≥ 80 years old) acute ischemic stroke (AIS) patients.

PATIENTS AND METHODS: The clinical data of patients who were treated in Tianjin Huanhu Hospital from June 2012 to November 2013 were retrospectively analyzed; amongst them 404 patients had received IVT with rt-PA and 200 patients had not received IVT. Among ≥80 years’ old patients, 204 had received IVT and 200 had not. And, the 404 patients who had received IVT, they were divided into two subgroups: elderly (≥ 80 years of age; n = 204) and controls (< 80 years old; n = 200). The incidence of intracranial hemorrhage (ICH) and symptomatic intracranial hemorrhage (sICH), case-fatality rate, and other prognostic indicators were compared.

RESULTS: Among all ≥80 years’ old patients, the IVT subgroup had significantly superior good outcome rates than the non-IVT subgroup at 24-h and 3-month, along with significantly lower case-fatality rate. But for the patients those who had received IVT, the incidence of ICH and the 7-day case-fatality rate were not significantly increased in both the elderly and control subgroups. The 24-h and 3-month good outcome rates were not significantly different between these two subgroups as well.

CONCLUSIONS: IVT with rt-PA is a safe and effective treatment for ≥ 80 year’s old AIS patients.

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