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Acute ischaemic stroke in patients aged 80 years and older: focus on the tolerability of thrombolytic agents.

作者信息

Poppe Alexandre Y, Hill Michael D

机构信息

Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.

出版信息

Drugs Aging. 2008;25(2):95-103. doi: 10.2165/00002512-200825020-00002.

DOI:10.2165/00002512-200825020-00002
PMID:18257597
Abstract

Ischaemic stroke is a devastating disease in the elderly with 30-50% 90-day mortality. Thrombolysis for stroke is potentially life saving and disability sparing in this group but the number of elderly patients studied in clinical trials, particularly those aged > or = 80 years, has been small. Indeed, < 50 patients aged > 80 years have been treated in clinical thrombolytic trials of ischaemic stroke. However, there is no evidence of a differential treatment effect by age. Multiple cohort studies have suggested that the risk of symptomatic intracerebral haemorrhage among octogenarians is no different from that in younger patients. Thrombolysis can be safely offered to acute ischaemic stroke patients aged > or = 80 years, although robust data from randomized clinical trials are relatively scarce.

摘要

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本文引用的文献

1
Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study.卒中溶栓监测研究(SITS-MOST)中阿替普酶用于急性缺血性卒中的溶栓治疗:一项观察性研究
Lancet. 2007 Jan 27;369(9558):275-82. doi: 10.1016/S0140-6736(07)60149-4.
2
Asymptomatic hemorrhage after thrombolysis may not be benign: prognosis by hemorrhage type in the Canadian alteplase for stroke effectiveness study registry.溶栓后无症状性出血可能并非良性:加拿大阿替普酶治疗卒中有效性研究登记中按出血类型的预后情况
Stroke. 2007 Jan;38(1):75-9. doi: 10.1161/01.STR.0000251644.76546.62. Epub 2006 Nov 22.
3
Intravenous thrombolysis in stroke patients of > or = 80 versus < 80 years of age--a systematic review across cohort studies.
≥80岁与<80岁中风患者的静脉溶栓治疗——一项队列研究的系统评价
Age Ageing. 2006 Nov;35(6):572-80. doi: 10.1093/ageing/afl104.
4
Underinvestigation and undertreatment of carotid disease in elderly patients with transient ischaemic attack and stroke: comparative population based study.老年短暂性脑缺血发作和中风患者颈动脉疾病的调查不足与治疗不足:基于人群的比较研究。
BMJ. 2006 Sep 9;333(7567):525-7. doi: 10.1136/bmj.38895.646898.55. Epub 2006 Jul 18.
5
Referral bias may underestimate number of very elderly patients eligible for rtPA.转诊偏倚可能会低估符合接受重组组织型纤溶酶原激活剂(rtPA)治疗条件的高龄患者数量。
Stroke. 2006 Apr;37(4):942-3; author reply 943. doi: 10.1161/01.str.0000210167.37729.eb.
6
Thrombolysis in patients older than 80 years with acute ischaemic stroke: Canadian Alteplase for Stroke Effectiveness Study.80岁以上急性缺血性卒中患者的溶栓治疗:加拿大阿替普酶治疗卒中有效性研究
J Neurol Neurosurg Psychiatry. 2006 Jul;77(7):826-9. doi: 10.1136/jnnp.2005.086595. Epub 2006 Feb 27.
7
Thrombolysis for acute stroke with special emphasis on the very old: experience from a single Dutch centre.急性卒中的溶栓治疗,特别关注高龄患者:来自荷兰单一中心的经验。
J Neurol Neurosurg Psychiatry. 2006 Mar;77(3):375-7. doi: 10.1136/jnnp.2005.070292.
8
Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study).基于人群的所有动脉区域急性血管事件的发生率、发病率、病死率和死亡率研究(牛津血管研究)。
Lancet. 2005 Nov 19;366(9499):1773-83. doi: 10.1016/S0140-6736(05)67702-1.
9
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Eur Neurol. 2005;54(3):140-4. doi: 10.1159/000089086. Epub 2005 Oct 18.
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Thrombolysis in stroke patients aged 80 years and older: Swiss survey of IV thrombolysis.80岁及以上中风患者的溶栓治疗:瑞士静脉溶栓调查
Neurology. 2005 Dec 13;65(11):1795-8. doi: 10.1212/01.wnl.0000183702.04080.27. Epub 2005 Oct 12.