Outcome of acute ischemic stroke in very elderly patients: Is intravenous thrombolysis beneficial?

European Neurology

Volumn 66, Issue 2, 2011, Pages 110-116

  Sung, Pi Shan ^a,b   Chen, Chih Hung ^a,b   Hsieh, Han Chieh ^a   Fang, Chen Wen ^a   Hsieh, Cheng Yang ^a   Sun, Yuan Ting ^a   Hwang, Wen Juh ^a  

^a NATIONAL CHENG KUNG UNIVERSITY   (Taiwan)

^b NATIONAL CHENG KUNG UNIVERSITY HOSPITAL   (Taiwan)

Author keywords

Elderly; Ischemic stroke; Minor stroke; Stroke outcome; Thrombolysis

Indexed keywords

ACETYLSALICYLIC ACID; ALTEPLASE;

ACUTE DISEASE; ACUTE ISCHEMIC STROKE; AGED; ANTICOAGULANT THERAPY; ARTICLE; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CHINESE; CIGARETTE SMOKING; CONTROLLED STUDY; DIABETES MELLITUS; DISEASE SEVERITY; DRUG CONTRAINDICATION; DRUG EFFICACY; DRUG SAFETY; FEMALE; FIBRINOLYTIC THERAPY; GENDER; HOSPITAL DISCHARGE; HUMAN; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PRIORITY JOURNAL; RANKIN SCALE; TREATMENT REFUSAL; TREATMENT RESPONSE; VERY ELDERLY;

AGED, 80 AND OVER; BRAIN; FEMALE; HUMANS; INJECTIONS, INTRAVENOUS; ISCHEMIC ATTACK, TRANSIENT; MALE; NEUROLOGIC EXAMINATION; RETROSPECTIVE STUDIES; SEVERITY OF ILLNESS INDEX; STATISTICS, NONPARAMETRIC; STROKE; THROMBOLYTIC THERAPY; TISSUE PLASMINOGEN ACTIVATOR; TREATMENT OUTCOME;

EID: 80051635989     PISSN: 00143022     EISSN: 14219913     Source Type: Journal    
DOI: 10.1159/000328429     Document Type: Article

References (33)

1. Dennis MS, Burn JP, Sandercock PA, Bamford JM, Wade DT, Warlow CP: Long-term survival after first-ever stroke: The Oxfordshire Community Stroke Project. Stroke 1993; 24: 796-800. (Pubitemid 23163551)
2. Chen RL, Balami JS, Esiri MM, Chen LK, Alastair M: Buchan AM. Ischemic stroke in the elderly: An overview of evidence. Nat Rev Neurol 2010; 6: 256-265.
3. Sharma JC, Fletcher S, Vassallo M: Strokes in the elderly -higher acute and 3-month mortality -an explanation. Cerebrovasc Dis 1999; 9: 2-9. (Pubitemid 29027608)
4. Vahedi K, Hofmeijer J, Juettler E, Vicaut E, George B, Algra A, Amelink GJ, Schmiedeck P, Schwab S, Rothwell PM, Bousser MG, van der Worp HB, Hacke W; DECIMAL, DESTINY, and HAMLET Investigators: Early decompressive surgery in malignant infarction of the middle cerebral artery: A pooled analysis of three randomised controlled trials. Lancet Neurol 2007; 6: 215-222. (Pubitemid 46237760)
5. Furlan A, Higashida R, Wechsler L, Gent M, Rowley H, Kase C, Pessin M, Ahuja A, Callahan F, Clark WM, Silver F, Rivera F, for the PROACT Investigators: Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: A randomized controlled trial. Prolyse in Acute cerebral thromboembolism. JAMA 1999; 282: 2003-2011.
6. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group: Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995; 333: 1581-1587.
7. Tanne D, Gorman MJ, Bates VE, Kasner SE, Scott P, Verro P, Binder JR, Dayno JM, Schultz LR, Levine SR: Intravenous tissue plasminogen activator for acute ischemic stroke in patients aged 80 years and older. The tPA Stroke Survey experience. Stroke 2000; 31: 370-375. (Pubitemid 30078168)
8. Berrouschot J, Rother J, Glahn J, Kucinski T, Fiehler J, Thomalla G: Outcome and severe hemorrhagic complications of intravenous thrombolysis with tissue plasminogen activator in very old ( 1 or =80 years) stroke patients. Stroke 2005; 36: 2421-2425. (Pubitemid 41566970)
9. Chen CI, Iguchi Y, Grotta JC, Garami Z, Uchino K, Shaltoni H, Alexandrov AV: Intravenous TPA for very old stroke patients. Eur Neurol 2005; 54: 140-144. (Pubitemid 43004444)
10. Engelter ST, Reichhart M, Sekoranja L, Georgiadis D, Baumann A, Weder B, Muller F, Luthy R, Arnold M, Michel P, Mattle HP, Tettenborn B, Hungerbuhler HJ, Baumgartner RW, Sztajzel R, Bogousslavsky J, Lyrer PA: Thrombolysis in stroke patients aged 80 years and older: Swiss survey of IV thrombolysis. Neurology 2005; 65: 1795-1798.
11. Mouradian MS, Senthilselvan A, Jickling G, McCombe JA, Emery DJ, Dean N, Shuaib A: Intravenous rt-PA for acute stroke: Comparing its effectiveness in younger and older patients. J Neurol Neurosurg Psychiatry 2005; 76: 1234-1237. (Pubitemid 41208374)
12. Van Oostenbrugge RJ, Hupperts RM, Lodder J: Thrombolysis for acute stroke with special emphasis on the very old: Experience from a single Dutch centre. J Neurol Neurosurg Psychiatry 2006; 77: 375-377.
13. Parnetti L, Silvestrelli G, LanariA, Tambasco N, Apocchi G, Agnelli G, and Perugia Stroke and Neuroradiology Team: Efficacy of thrombolytic (rt-PA) therapy in old stroke patients: The Perugia Stroke Unit experience. Clin Exp Hypertens 2006; 28: 397-404. (Pubitemid 44178518)
14. Sylaja PN, Cote R, Buchan AM, Hill MD on behalf of Canadian Alteplase for Stroke Effectiveness Study (CASES) Investigators: Thrombolysis in patients older than 80 years with acute ischaemic stroke: Canadian Alteplase for Stroke Effectiveness Study. J Neurol Neurosurg Psychiatry 2006; 77: 826-829. (Pubitemid 44023176)
15. Ringleb PA, Schwark Ch, Kohrmann M, Kulkens S, Juttler E, Hacke W, Schellinger PD: Thrombolytic therapy for acute ischaemic stroke in octogenarians: Selection by magnetic resonance imaging improves safety but does not improve outcome. J Neurol Neurosurg Psychiatr 2007; 78:690-693. (Pubitemid 46998836)
16. Uyttenboogaart M, Schrijvers EM, Vroomen PC, De Keyser J, Luijckx GJ: Routine thrombolysis with intravenous tissue plasminogen activator in acute ischaemic stroke patients aged 80 years or older: A single-centre experience. Age Ageing 2007; 36: 577-579. (Pubitemid 47558837)
17. Zeevi N, Chhabra J, Silverman IE, Lee NS, McCullough LD: Acute stroke management in the elderly. Cerebrovasc Dis 2007; 23: 304-308. (Pubitemid 46425800)
18. Gomez-Choco M, Obach V, Urra X, Amaro S, Cervera A, Vargas M, Chamorro A: The response to IV rt-PA in very old stroke patients. Eur J Neurol 2008; 15: 253-256. (Pubitemid 351257917)
19. Meseguer E, Labreuche J, Olivot JM, Abboud H, Lavallee PC, Simon O, Cabrejo L, Echeverria A, Klein IF, Mazighi M, Amarenco P: Determinants of outcome and safety of intravenous rt-PA therapy in the very old: A clinical registry study and systematic review. Age Ageing 2008; 37: 107-111. (Pubitemid 351146986)
20. Toni D, Lorenzano S, Agnelli G, Guidetti D, Giovanni Orlandi G, Semplicini A, Toso V, Caso V, Malferrari G, Fanucchi S, Bartolomei L, Prencipe M: Intravenous thrombolysis with rt-PA in acute ischemic stroke patients aged older than 80 years in Italy. Cerebrovasc Dis 2008; 25: 129-135. (Pubitemid 351280387)
21. Derex L, Nighoghossian N: Thrombolysis, stroke-unit admission and early rehabilitation in elderly patients. Nat Rev Neurol 2009; 5: 506-511.
22. Longstreth WT Jr, Katz R, Tirschwell DL, Cushman M, Psaty BM: Intravenous tissue plasminogen activator and stroke in the elderly. Am J Emerg Med 2010; 28: 359-363.
23. Barber PA, Zhang J, Demchuk AM, Hill MD, Buchan AM: Why are stroke patients excluded from TPA therapy? An analysis of patient eligibility. Neurology 2001; 56: 1015-1020. (Pubitemid 32336306)
24. Smith EE, Abdullah AR, Petkovska I, Rosenthal E, Koroshetz WJ, Schwamm LH: Poor outcomes in patients who do not receive intravenous tissue plasminogen activator because of mild or improving ischemic stroke. Stroke 2005; 36: 2497-2499. (Pubitemid 41566987)
25. Rajajee V, Kidwell C, Starkman S, Ovbiagele B, Alger JR, Villablanca P, Vinuela F, Duckwiler G, Jahan R, Fredieu A, Suzuki S, Saver JL: Early MRI and outcomes of untreated patients with mild or improving ischemic stroke. Neurology 2006; 67: 980-984. (Pubitemid 44454588)
26. Hsieh FI, Lien LM, Chen ST, Bai CH, Sun MC, Tseng HP, Chen YW, Chen CH, Jeng JS, Tsai SY, Lin HJ, Liu CH, Lo YK, Chen HJ, Chiu HC, Lai ML, Lin RT, Sun MH, Yip BS, Chiou HY, Hsu CY, the Taiwan Stroke Registry Investigators: Get with the guidelinesstroke performance indicators: Surveillance of stroke care in the Taiwan Stroke Registry. Circulation 2010; 122: 1116-1123.
27. Huang P, Chen CH, Yang YH, Lin RT, Lin FC, Liu CK: Eligibility for recombinant tissue plasminogen activator in acute ischemic stroke: Way to endeavor. Cerebrovasc Dis 2006; 22: 423-428. (Pubitemid 44681119)
28. Engelter ST, Bonati LH, Lyrer PA: Intravenous thrombolysis in stroke patients of 6 80 versus ! 80 years of age -a systematic review across cohort studies. Age Ageing 2006; 35: 572-580. (Pubitemid 44614151)
29. Coutts SB, Barber PA, Demchuk AM, Hill MD, Pexman JHW, Hudon ME, Buchan AM: Mild neurological symptoms despite middle cerebral artery occlusion. Stroke 2004; 35: 469-471. (Pubitemid 38180445)
30. Nedeltchev K, Schwegler B, Haefeli T, Brekenfeld C, Gralla J, Fischer U, Arnold M, Remonda L, Schroth G, Mattle HP: Outcome of stroke with mild or rapidly improving symptoms. Stroke 2007; 38: 2531-2535. (Pubitemid 47329633)
31. Kohrmann M, Nowe T, Huttner HB, Engelhorn T, Struffert T, Kollmar R, Saake M, Doerfler A, Schwab S, Schellinger PD: Safety and outcome after thrombolysis in stroke patients with mild symptoms. Cerebrovasc Dis 2009; 27: 160-166.
32. Whiteley W, Lindley R, Wardlaw J, Sandercock P: Third international stroke trial. Int J Stroke 2006; 1: 172-176. (Pubitemid 44151513)
33. Toni D, Lorenzano S: Intravenous thrombolysis with rt-PA in acute stroke patients aged 6 80 years. Int J Stroke 2009; 4: 21-22.