Safety and Effectiveness of Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator in 80 Years and Older Acute Ischemic Stroke Patients

This study aims to explore the safety and efficacy of intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) in elderly (≥80 years old) acute ischemic stroke (AIS) patients. The clinical data of patients who were treated in Tianjin Huanhu Hospital from June 2012 to November 2013 were retrospectively analyzed; among them, 404 patients had received IVT with rt-PA and 200 patients had not received IVT. Among ≥80-year-old patients, 204 had received IVT and 200 had not. And the 404 patients who had received IVT were divided into two subgroups: elderly (≥80 years of age; n = 204) and controls (<80 years old; n = 200). The incidence of intracranial hemorrhage (ICH) and symptomatic intracranial hemorrhage, case fatality rate, and other prognostic indicators were compared. Among all ≥80-year-old patients, the IVT subgroup had significantly superior good outcome rates than the non-IVT subgroup at 24-h and 3-month along with significantly lower case fatality rate. But for the patients those who had received IVT, the incidence of ICH and the 7-day case fatality rate were not significantly increased in both the elderly and control subgroups. The 24-h and 3-month good outcome rates were not significantly different between these two subgroups as well. IVT with rt-PA is a safe and effective treatment for ≥80-year-old AIS patients.