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Intravenous Thrombolysis for Acute Ischaemic Stroke in Young Adult Patients

Published online by Cambridge University Press:  04 July 2016

Alexandre Y. Poppe ,
Alastair M. Buchan  and
Michael D. Hill
Alexandre Y. Poppe*
Affiliation:
Calgary Stroke Program, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
Alastair M. Buchan
Affiliation:
Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford, United Kingdom
Michael D. Hill
Affiliation:
Department of Clinical Neurosciences / Medicine / Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
*
Calgary Stroke Program, University of Calgary, Foothills Medical Centre, 1403 29th Street NW, Calgary, Alberta, T2N 2T9, Canada
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Abstract

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Background:

Intravenous tissue plasminogen activator (IV tPA) has been studied primarily in patients over age 50. We sought to describe baseline differences in adult patients ≤50 years-old taken from a large prospective cohort of acute stroke patients treated with intravenous tPA (IV tPA) and to determine whether outcomes differed for this population.

Methods:

Data (n = 1120) prospectively collected from the Canadian Alteplase for Stroke Effectiveness Study (CASES) were reviewed and patients aged ≤50 years-old (n=99) were compared with those aged >50 years (n=1021) with regards to baseline characteristics, symptomatic intracerebral haemorrhage (sICH), functional outcome at 90 days and death.

Results:

Nine percent of patients were ≤50 years-old. Among patients aged ≤50 years, 40.4% were women and median age was 42 ± 6.1 years (range 20 to 50). They had significantly more current cigarette use but fewer other vascular risk factors than older patients (p<0.05) and their baseline median NIHSS score was lower (13 versus 15, P=0.001). Although this group was more likely to have a favourable 90-day outcome, multivariable regression confirmed that age ≤50 years, while independently associated with a decreased risk of death (RR 0.36, 95% CI 0.14 to 0.95), was not itself predictive of favourable 90-day outcome or decreased risk of sICH.

Conclusions:

Adult patients ≤50 years-old had fewer medical co-morbidities and a modestly lower baseline median NIHSS score than their older counterparts. Age ≤50 years was independently associated with a decreased risk of death but not with favourable outcome or risk of sICH.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 2 , March 2009 , pp. 161 - 167
Copyright
Copyright © The Canadian Journal of Neurological 2009

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