title: Intravenous thrombolysis for acute ischaemic stroke in young adult patients.
abstract: BACKGROUND
  Intravenous tissue plasminogen activator (IV tPA) has been studied primarily in patients over age 50. We sought to describe baseline differences in adult patients < or = 50 years-old taken from a large prospective cohort of acute stroke patients treated with intravenous tPA (IV tPA) and to determine whether outcomes differed for this population.
  
  
  METHODS
  Data (n = 1120) prospectively collected from the Canadian Alteplase for Stroke Effectiveness Study (CASES) were reviewed and patients aged < or = 50 years-old (n = 99) were compared with those aged > 50 years (n = 1021) with regards to baseline characteristics, symptomatic intracerebral haemorrhage (sICH), functional outcome at 90 days and death.
  
  
  RESULTS
  Nine percent of patients were < or = 50 years-old. Among patients aged < or = 50 years, 40.4% were women and median age was 42 +/- 6.1 years (range 20 to 50). They had significantly more current cigarette use but fewer other vascular risk factors than older patients (p < 0.05) and their baseline median NIHSS score was lower (13 versus 15, P = 0.001). Although this group was more likely to have a favourable 90-day outcome, multivariable regression confirmed that age < or = 50 years, while independently associated with a decreased risk of death (RR 0.36, 95% CI 0.14 to 0.95), was not itself predictive of favourable 90-day outcome or decreased risk of sICH.
  
  
  CONCLUSIONS
  Adult patients < or = 50 years-old had fewer medical co-morbidities and a modestly lower baseline median NIHSS score than their older counterparts. Age < or = 50 years was independently associated with a decreased risk of death but not with favourable outcome or risk of sICH.
authors.affiliation: Calgary Stroke Program, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada.
authors.forename: Alexandre Y
authors.initials: AY
authors.lastname: Poppe
authors.forename: Alastair M
authors.initials: AM
authors.lastname: Buchan
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator