Efficacy of thrombolytic (rt-PA) therapy in old stroke patients: the Perugia Stroke Unit experience.
The use of intravenous recombinant tissue plasminogen activator (rt-PA) administered within 3 hrs from symptom onset is beneficial in selected patients independent of age; although oldest patients (> or = 80 years) are excluded a priori. We report an experience relative to rt-PA treatment in the oldest patients including outcome at 3 months. Data were from the hospital-based Perugia Stroke Registry. Seventy-two consecutive acute stroke patients, fulfilling NINDS and EUSI-criteria were treated with rt-PA of these 23 patients (30.5%) were > or = 80 years. The median and mean age were, respectively, 72.5 and 71.1 +/- 12.7 years (range 35-94). The proportion of favorable outcome at 3-months did not differ between groups (55% elderly versus 51.1% of younger patients). Proportions of unfavorable outcome and death from baseline were similar in both groups of patients. Age did not influence prognosis in patients treated with rt-PA. The oldest stroke patients should not be excluded from rt-PA treatment on the basis of age per se.
Parnetti
Lucilla
L
Stroke Unit, Department of Neuroscience, University of Perugia, Perugia, Italy. parnetti@unipg.it
Silvestrelli
Giorgio
G
Lanari
Alessia
A
Tambasco
Nicola
N
Capocchi
Giuseppe
G
Agnelli
Giancarlo
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D007558:Italy; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use*; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014505:Urban Population
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator