Abstract
The use of rtPA in stroke patients aged >80 years remains controversial and it is debated whether there are sex-based differences in the response to rtPA. We assessed the clinical value of thrombolytic therapy in patients aged >80 years (elderly group) in comparison with a non-elderly group, and evaluated the existence of sex differences in the response to rtPA. All consecutive patients (n = 157) treated with rtPA were prospectively assessed since July 2001, including 49 elderly patients who fulfilled the National Institute of Neurological Disorders and Stroke (NINDS) criteria. Changes of the National Institute of Health Stroke Scale (NIHSS) score at 1 h, 24 h, and 7 days after rtPA administration, favourable outcome at day 90 [(modified Rankin Scale) mRS 0-1, or 2 if mRS = 2 before the stroke], symptomatic bleedings, and death rates were compared between elderly and non-elderly patients. Using logistic regression, baseline NIHSS score [odds ratio (OR) 0.59, 95% confidence interval (CI) 0.41-0.84] was an independent predictor of favourable outcome, but not sex (OR 0.72, 95% CI 0.33-1.56), or age >80 years (OR 0.74, 95% CI 0.32-1.70). The rates of clinical improvement, mortality, or symptomatic CNS bleeding were also unrelated t...Continue Reading
References
Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Jan 1, 1993·Stroke; a Journal of Cerebral Circulation·H P AdamsE E Marsh
Feb 5, 2000·Stroke; a Journal of Cerebral Circulation·D TanneS R Levine
Feb 26, 2000·Lancet·R Holliday
Jun 1, 2000·Journal of Neurotrauma·R L Roof, E D Hall
Mar 16, 2004·Lancet·Werner HackeUNKNOWN NINDS rt-PA Study Group Investigators
Dec 1, 2004·Stroke; a Journal of Cerebral Circulation·David M KentHarry P Selker
Oct 8, 2005·Stroke; a Journal of Cerebral Circulation·Jörg BerrouschotGötz Thomalla
Oct 14, 2005·Neurology·S T EngelterP A Lyrer
Oct 26, 2005·Neurology·Gustavo SaposnikVladimir Hachinski
Feb 18, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·R J van OostenbruggeJ Lodder
Mar 1, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·P N SylajaUNKNOWN Canadian Alteplase for Stroke Effectiveness Study (CASES) Investigators
Oct 19, 2006·Age and Ageing·Stefan T EngelterPhilippe A Lyrer
Oct 24, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·P A RinglebP D Schellinger
Jan 30, 2007·Lancet·Nils WahlgrenUNKNOWN SITS-MOST investigators
Mar 14, 2007·Neurology·M S V ElkindUNKNOWN GAIN Americas Investigators
Citations
Dec 21, 2011·Journal of Neurology·Gregoire BoulouisHilde Hénon
Jan 23, 2013·Drugs & Aging·Hakan Sarikaya
Dec 1, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Varun AgrawalPeter A McCullough
Sep 8, 2011·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·M GuillanJ Masjuan
Aug 19, 2011·European Neurology·Pi-Shan SungWen-Juh Hwang
Aug 21, 2013·Clinical Interventions in Aging·Josef Yayan
Nov 28, 2012·Clinics in Geriatric Medicine·Laura E Heitsch, Peter D Panagos
Nov 28, 2012·Clinics in Geriatric Medicine·Christopher R Carpenter, Timothy F Platts-Mills
Apr 3, 2012·Techniques in Vascular and Interventional Radiology·Francesca Tari CaponeFrancesco Orzi
Jan 21, 2011·The American Journal of Emergency Medicine·Haralabos ZacharatosAdnan I Qureshi
Sep 4, 2010·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Sheila Cristina Ouriques MartinsAyrton Roberto Massaro
Mar 13, 2010·The American Journal of Emergency Medicine·W T LongstrethBruce M Psaty
Jan 1, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Maarten M H LahrErik Buskens
Dec 11, 2013·Geriatrics & Gerontology International·Ryu MatsuoUNKNOWN FSR investigators
Aug 1, 2012·Stroke Research and Treatment·Juan García-CaldenteyJaime Masjuan
Jun 24, 2014·Atencion primaria·Jose Luis Clua-EspunyM Lluisa Queralt-Tomas
Oct 21, 2014·PloS One·Ryu MatsuoUNKNOWN FSR Investigators
Sep 13, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Megan FredwallThomas I Nathaniel
Jan 7, 2009·Revue neurologique·L SuissaM-H Mahagne
Apr 18, 2009·Stroke; a Journal of Cerebral Circulation·Elena MeseguerPierre Amarenco
Dec 24, 2015·Stroke; a Journal of Cerebral Circulation·Bart M DemaerschalkUNKNOWN American Heart Association Stroke Council and Council on Epidemiology and Prevention
Oct 17, 2009·Stroke; a Journal of Cerebral Circulation·Hannelore EhrenreichUNKNOWN EPO Stroke Trial Group
Jun 19, 2008·Nature Clinical Practice. Neurology·Robert J Wityk
Aug 5, 2009·Nature Reviews. Neurology·Laurent Derex, Norbert Nighoghossian
Apr 7, 2016·NPJ Microgravity·Jessica AcetoMarc Muller
Apr 10, 2018·Journal of Clinical Neurology·Mingsu LiuMaoting Yuan