Abstract

EIRA, Carla et al. Intravenous Thrombolysis for Acute Ischemic Stroke After the 80 Years of Age. Medicina Interna [online]. 2018, vol.25, n.3, pp.169-178. ISSN 0872-671X.  https://doi.org/10.24950/rspmi/original/189/3/2018.

Introduction: The incidence of stroke increases exponentially with age, representing the leading cause of death after the 80 years of age. Intravenous thrombolysis with recombinant tissue plasminogen activator (IV-rtPA) represents an advance in the treatment of ischemic stroke and its use in the elderly > 80 years old was a recent target of discussion. Material and Methods: A retrospective study was performed in the 2010-2015 period that included patients >80 years old with ischemic stroke who underwent IV-rtPA. The study evaluated demographic and clinical variables, occurrence of hemorrhagic transformation and prognosis. Statistical analysis was performed using SPSS software. Results: We included 45 patients, mean age 84.4 years old and female predominance (62.2%). The main risk factors were arterial hypertension (68.9%) and cardioembolism (62.2%). In most cases, IV-rtPA was performed until 3 hours (82.2%). hemorrhagic transformation occurred in 22.2%, with worse prognosis at 3 months (p = 0.000). Lower severity of stroke and length of hospital stay were associated with better prognosis at 3 months (p = 0.025 and p = 0.005, respectively). Discussion: Some of these results are in agreement with data from other studies. The increase in age is associated with a worse prognosis. hemorrhagic transformation is one of IV-rtPA concerns. The incidence of arterial hypertension and atrial fibrillation increases with age, both associated with an increased risk of stroke. Conclusion: The safety of IV-rtPA has been demonstrated in several studies. Age should not be an exclusion criterion, since properly selected patients may benefit from such therapy

Keywords : Aged, 80 and over; Stroke; Thrombolytic Therapy; Tissue Plasminogen Activator.

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