Efficacy and safety of intravenous thrombolysis in young adults with acute ischemic stroke

Abstract

Introduction: Stroke in young people has a major socioeconomic impact, since up to 30% of young patients may die or have permanent sequelae with expected longer survival than older patients. Aim: The aim is to investigate the efficacy and safety of intravenous thrombolysis in the young adults with acute ischemic stroke (AIS) comparing to elderly patients. Material and Methods: A total of 403 patients suffering from AIS treated with intravenous thrombolysis, were divided by age into two groups: patients aged 18 to 45 (n = 59) and patients older than 45 years (n = 344). The functional outcome, assessed by modified Rankin scale (mRS), was used as a measure of therapy efficacy, and the presence of symptomatic intracerebral hemorrhage (sICH) and mortality as a measure of thrombolysis safety. The follow-up period was 3 months after stroke onset. Results: There were no difference between two groups of patients in excellent functional outcome (mRS ≤ 1) (p = 0.149) and good functional outcome (mRS ≤ 2) (p = 0.156), while the rate of death was significantly lower in the group of younger patients (18-45 years 5.2% vs. > 45 years 17.0% , p = 0.019). Also, there was no statistically significant difference in the presence and type of sICH between these 2 groups of patients. Conclusion: There is no significant difference in good and excellent functional outcome, as well as the incidence of sICH in young adult patients with AIS treated with intravenous thrombolysis, compared to the older patients. The fatal outcome is lower in the group of younger AIS patients.