Efficacy and safety of intravenous thrombolytic therapy in patients over eighty years

Abstract

Introduction: Intravenous thrombolytic therapy (IVTT) is licensed for patients under 80 years in many countries. In this study, we aimed to demonstrate functional results and complication rates of IVTT in patients over eighty years and whether there is a difference in efficacy and safety between low dose and standard dose recombinant tissue plasminogen activator (rTPA).

Methods: A retrospective observational study of patients over eighty who admitted to Suleyman Demirel University Faculty of Medicine Hospital between August 2016 and April 2021 and to Isparta City Hospital between April 2017 and April 2021 and diagnosed with acute ischemic stroke were conducted. Third month modified rankin scores (mRS) and mortality rates of patients and hemorrhagic transformations were determined.

Results: There were 29 patients in IVTT group and 25 patients in non-IVTT group. By the third month, it was observed that functional independence (mRS 0-2) ratio was increased more in IVTT group, but it wasn't statistically significant (p: 0.087). In mortality and symptomatic intracerebral hemorrhage rates, there wasn't statistically significant difference between IVTT and non-IVTT groups and low dose and standard dose rTPA groups by the third month.

Conclusion: The efficacy and complication rates of IVTT in patients over 80 years were found similar to not receive IVTT. These results support the safety of IVTT in patients over 80 years. In low or standard dose rTPA preference, we observed that there was not statistically significance in efficacy and safety. We believe that these results will be supported by studies with larger number of patients.

Keywords: Acute ischemic stroke; eighty years old; hemorrhagic transformation; thrombolytic therapy; treatment outcome.