Effectiveness of intravenous recombinant plasminogen activator treatment in Chinese patients with acute ischaemic stroke aged over 80 years: a retrospective cohort study.

Nevertheless, the near-significant trend towards a higher ICH rate in the intravenous rt-PA group warrants caution and highlights the importance of individualised risk assessments and close monitoring for elderly or high-risk patients when considering intravenous rt-PA therapy.

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Previously, the randomised controlled IST-3 study showed that intravenous rt-PA treatment was associated with improved survival in the longer term (up to 3 years) in patients aged >80 years who received intravenous rt-PA compared with those who did not receive intravenous rt-PA, although this difference did not reach statistical significance (mortality at 3 years: 59.5% vs 64.7% in intravenous rt-PA treated and untreated groups, respectively). 28 Further longer-term studies are required to better understand the impact of intravenous rt-PA treatment on mortality in patients with AIS aged >80 years.

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