Intravenous Thrombolysis with rt-PA in Acute Ischemic Stroke Patients Aged Older than 80 Years in Italy

• DOI: 10.1159/000112323
• Publication Date: 2007-12-14T10:31:44Z
• Authors: Danilo Toni; Svetlana Lorenzano; Giancarlo Agnelli; Donata Guidetti; Giovanni Orlandi; Andrea Semplicini; Vito Toso; Valeria Caso; Giovanni Malferrari; Simona Fanucchi; Luigi Bartolomei; Massimiliano Pren...
• Keywords: Stroke

<i>Background:</i> Intravenous (i.v.) thrombolysis with rt-PA within 3 h from symptom onset is the only approved treatment of pharmacological revascularization in acute ischemic stroke. However, little information exists on its use elderly patients, particular those aged >80 years, who at present are excluded treatment. <i>Methods:</i> In a multicenter Italian study i.v. thrombolysis, patients years (n = 41) were compared ≤80 207) regarding percentage symptomatic (nonfatal and fatal) intracerebral hemorrhage (SICH), favorable 3-month functional outcome (modified Rankin Scale score 0–2) poor (death or dependence, i.e. modified 3–5). <i>Results:</i> The SICH was comparable between older (2.4%, 2.4%) younger patient groups (p 1.0). At months, occurred 44% dependence 22% older, respectively 58.5 30.9% 0.897). Patients had higher mortality (34.1%) as to (10.6%) < 0.001). Baseline National Institute Health Stroke statistically significant predictor both (OR 1.26; 95% CI 1.07–1.50) 1.39; 1.14–1.68) >80-year-old group. <i>Conclusions:</i> Acute stroke treated have than but there no differences for nor outcome. Our data suggest that thrombolytic therapy should not be priori denied appropriately selected randomized controlled clinical trials necessary before definite recommendations can given.