Age-dependent effect of thrombolytics on likelihood of National Institutes of Health Stroke Scale improvement in minor strokes

Abstract

The appropriate acute treatment strategy for minor ischemic stroke, defined as National Institutes of Health Stroke Scale scores ≤5, is not as well-defined. Prior studies have demonstrated mixed results regarding the effects of neurovascular interventions on minor stroke patients for optimizing the chances of symptomatic improvement. We performed a retrospective single-center study across 6 years to determine the association between thrombolytics and the likelihood of clinical symptom improvement by 24 h in minor stroke patients across ages. Margin plots were derived from multivariable regression analyses. Of 1172 minor stroke patients, in patients <70 years of age, there was greater than 50% likelihood of improvement with any type of thrombolytic administration. When substratifying by type of thrombolytic, there is greater than 50% odds of improvement in patients <80 years of age treated with alteplase and <70 years of age treated with tenecteplase. Thus, the association between age and likelihood of benefit after thrombolytic treatment in minor stroke patients highlights particular minor stroke subpopulations, particularly younger patients, who may benefit from thrombolytic treatment.

Keywords

acute ischemic stroke / alteplase / tenecteplase / thrombolysis

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RIGHTS & PERMISSIONS

2025 The Author(s). Ibrain published by Affiliated Hospital of Zunyi Medical University (AHZMU) and Wiley-VCH GmbH.