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Misleading conclusions on rt-PA treatment in the very elderly

¹ Department of Neurology, University Medical Centre Groningen, Groningen 9700 RB, Netherlands; c.a.j.vroomen@neuro.umcg.nl

Keywords: rt-PA treatment; elderly

The first 150 words of the full text of this article appear below.

The effectiveness of rt-PA in the elderly is an important but as yet incompletely resolved topic. In a recent paper in this journal,¹ Mouradian et al provide convincing data that patients older than 80 years who receive rt-PA are less likely to have a favourable outcome than their younger counterparts. This is in keeping with our own data showing that 5 of 24 patients (21%) treated with rt-PA aged 80 years or older were independent (mRS 0–2) after three months, compared with 39 of 77 patients younger than 80 years (51%).

However, their data and ours provide no indication that rt-PA is less effective in the elderly. The chance of a favourable outcome from a stroke declines with advancing age.² To show that the effectiveness of rt-PA decreases with age, the authors would need to have demonstrated that the worse outcome in the very elderly with rt-PA is more pronounced . . . [Full text of this article]

A Shuaib, M Muratoglu

Correspondence to:
Correspondence to:
Division of Neurology and Stroke Program
University of Alberta, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada; ashfaq.shuaib@ualberta.ca

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