Safety and Effectiveness of Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator in 80 Years and Older Acute Ischemic Stroke Patients

Cell Biochem Biophys. 2015 Jul;72(3):883-8. doi: 10.1007/s12013-015-0556-1.

Abstract

This study aims 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. The clinical data of patients who were treated in Tianjin Huanhu Hospital from June 2012 to November 2013 were retrospectively analyzed; among them, 404 patients had received IVT with rt-PA and 200 patients had not received IVT. Among ≥80-year-old patients, 204 had received IVT and 200 had not. And the 404 patients who had received IVT 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, case fatality rate, and other prognostic indicators were compared. Among all ≥80-year-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. IVT with rt-PA is a safe and effective treatment for ≥80-year-old AIS patients.

Keywords: 80 years; Acute ischemic stroke; Elderly; Intravenous thrombolysis; Recombinant tissue plasminogen activator.

Publication types

  • Clinical Study

MeSH terms

  • Administration, Intravenous
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / drug therapy*
  • Case-Control Studies
  • Female
  • Humans
  • Intracranial Hemorrhages / epidemiology
  • Intracranial Hemorrhages / etiology*
  • Male
  • Plasminogen Activators / administration & dosage
  • Plasminogen Activators / adverse effects*
  • Plasminogen Activators / therapeutic use
  • Stroke / drug therapy*
  • Thrombolytic Therapy / adverse effects*

Substances

  • Plasminogen Activators