Safety and efficacy of thrombolysis with intravenous alteplase in older stroke patients.

Sarikaya, Hakan (2013). Safety and efficacy of thrombolysis with intravenous alteplase in older stroke patients. Drugs & aging, 30(4), pp. 227-234. Adis International 10.1007/s40266-013-0052-5

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Stroke is a common cause of death and persisting disability worldwide, and thrombolysis with intravenous alteplase is the only approved treatment for acute ischaemic stroke. Older age is the most important non-modifiable risk factor for stroke, and demographic changes are also resulting in an increasingly ageing population. However, clinical trial evidence for the use of intravenous alteplase is limited for the older age group where stroke incidence is highest. In this article, the current evidence regarding the safety and efficacy of intravenous thrombolytic therapy in stroke patients aged ≥80 years is critically analysed and the gap in current knowledge highlighted. In summary, intravenous thrombolysis in stroke patients aged ≥80 years seems to be associated with less favourable clinical outcomes and higher mortality than in younger patients, which is consistent with the natural course in untreated patients. The risk of symptomatic intracranial haemorrhage does not appear to be significantly higher in the elderly group, suggesting that intracranial bleeding complications are unlikely to outweigh the potential benefit in this age group. Overall, withholding thrombolytic treatment in ischaemic stroke on the basis of advanced age alone is no longer justifiable.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Sarikaya, Hakan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1170-229X

Publisher:

Adis International

Language:

English

Submitter:

Valentina Rossetti

Date Deposited:

18 Jun 2014 13:54

Last Modified:

18 Jun 2014 13:54

Publisher DOI:

10.1007/s40266-013-0052-5

PubMed ID:

23338796

URI:

https://boris.unibe.ch/id/eprint/53562

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