Send to

Choose Destination
Geriatr Gerontol Int. 2014 Oct;14(4):954-9. doi: 10.1111/ggi.12205. Epub 2013 Dec 9.

Thrombolytic therapy with intravenous recombinant tissue plasminogen activator in Japanese older patients with acute ischemic stroke: Fukuoka Stroke Registry.

Author information

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.



The present study aimed to determine the efficacy and safety of thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) therapy in older patients compared with younger patients.


Using the Fukuoka Stroke Registry, a prospective multicenter study for acute stroke in Japan, we analyzed data of 401 patients with acute ischemic stroke (aged 74.5 ± 13.1 years) treated with thrombolytic therapy using rt-PA. Patients were categorized into two groups according to age: those aged ≥ 75 years (n=240) and <75 years (n=161). Neurological improvement was defined as a decrease in the National Institute of Health Stroke Scale (NIHSS) score of ≥ 4 during hospitalization or an NIHSS score of 0 at discharge. Good functional outcome was defined as a modified Rankin scale score of 0-2 at 3 months after onset.


Neurological symptoms at admission were more severe in older patients than in younger patients. Old age (≥ 75 years) was not associated with neurological deterioration (multivariate-adjusted odds ratio [OR] 0.90, 95% confidence interval [CI] 0.46-1.77), neurological improvement (multivariate-adjusted OR 0.91, 95% CI 0.54-1.53) and symptomatic intracranial hemorrhage (multivariate-adjusted OR 1.11, 95% CI 0.19-8.87). Old age was negatively associated with good functional outcome (multivariate-adjusted OR 0.29, 95% CI 0.16-0.52) and positively associated with in-hospital mortality (multivariate-adjusted OR 19.3, 95% CI 2.4-474.9).


In patients treated with rt-PA, old age is associated with poor functional outcome and in-hospital mortality. However, the probability of neurological improvement and symptomatic intracranial hemorrhage in older patients is comparable with that in younger patients.


aged; brain infarction; functional outcome; thrombolysis; tissue plasminogen activator

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center