title: Safety of intravenous thrombolysis for ischaemic stroke in Asian octogenarians and nonagenarians.
abstract: BACKGROUND
  symptomatic intracerebral haemorrhage (ICH) is a major concern of intravenous thrombolysis (IVT) for ischaemic stroke. Asians are considered more vulnerable to ICH than non-Asians. Reports on safety of IVT for Asian octogenarians and nonagenarians are limited.
  
  
  OBJECTIVE
  the aims of our study were to compare the safety of IVT between octogenarians and nonagenarians and between Asian and Western patients.
  
  
  METHODS
  patients receiving IVT for ischaemic stroke were prospectively registered from four hospitals in Taiwan. Octogenarians and nonagenarians were recruited for analysis. The primary safety outcome measure was symptomatic ICH. The secondary outcome measure was 3-month mortality. We searched the literature on IVT for ischaemic stroke for comparison.
  
  
  RESULTS
  from January 2007 to December 2012, a total of 186 (18.3%) ischaemic stroke patients aged 80 and older, including 166 octogenarians and 20 nonagenarians, were recruited from 1,018 patients receiving IVT. Nine (4.8%) of recruited patients had symptomatic ICH, all in the octogenarian group (5.4%). Three-month mortality was 14.1% in recruited patients and without difference between the two age groups (P = 0.558). The results were comparable with reports on Western octogenarians and nonagenarians in the literature.
  
  
  CONCLUSIONS
  octogenarians and nonagenarians receiving IVT have a similar safety outcome. Asian octogenarians and nonagenarians receiving IVT for ischaemic stroke are not at higher risk of symptomatic ICH and mortality than Western patients.
authors.affiliation: Stroke Center, Changhua Christian Hospital, Changhua, Taiwan Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Mu-Chien
authors.initials: MC
authors.lastname: Sun
authors.affiliation: Stroke Center, Changhua Christian Hospital, Changhua, Taiwan Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Tien-Bao
authors.initials: TB
authors.lastname: Lai
authors.affiliation: Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
authors.affiliation: Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
authors.forename: Sheng-Feng
authors.initials: SF
authors.lastname: Sung
authors.affiliation: Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Pi-Shan
authors.initials: PS
authors.lastname: Sung
authors.affiliation: Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Sung-Chun
authors.initials: SC
authors.lastname: Tang
authors.affiliation: Stroke Center, Changhua Christian Hospital, Changhua, Taiwan Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Wei-Liang
authors.initials: WL
authors.lastname: Chen
authors.affiliation: Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Chen
mesh_terms: D061605:Administration, Intravenous; D000369:Aged, 80 and over; D044466:Asian People; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000401:mortality; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology / Q000401:mortality; D013624:Taiwan; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Asians; acute ischaemic stroke; intracerebral haemorrhage; intravenous thrombolysis; older people