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4 - WAKE-UP: AGE AND TREATMENT RESPONSE AFTER THROMBOLYSIS IN STROKE PATIENTS WITH UNKNOWN ONSET

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ESOC-2019

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Abstract

Background―The influence of age on the treatment effect of thrombolysis is unknown in patients with wake-up stroke. Methods―All patients screened in the WAKE-UP trial with diffusion-weighted imaging (DWI) were eligible for this pre-specified substudy. Clinical characteristics were compared between young (<55 years) vs. old (≥55 years) patients and among age quartiles. Among randomized patients, the treatment effect of thrombolysis was compared between young vs. old patients and across quartiles of age using logistic regression analyses. Results―Overall, 1,101 patients included in WAKE-UP had a DWI lesion on MRI of which 181 patients (16.4%) were <55 years old. Older patients were more likely to have arterial hypertension (20.4% vs. 60.4%), atrial fibrillation (3.3% vs. 9.7%), hypercholesterolemia (13.8% vs. 36.3%), and diabetes mellitus (7.2% vs. 18.4%, all p<0.01). Younger patients demonstrated a higher proportion of current smokers (55.4% vs. 26.4%, p<0.01) and larger mean DWI lesion volumes (20.8 vs. 13.1 ml, p=0.01). Among randomized patients (n=490), age had no effect on the treatment effect of thrombolysis neither when comparing young vs. old patients nor using quartiles of age (p for interaction: 0.96 and 0.80, respectively). Conclusions―In stroke patients with unknown onset enrolled in WAKE-UP, risk factors differed by age. Age had no significant effect on the treatment effect of thrombolysis. Therefore, our data do not support age as a criterion for therapeutic decision making in this stroke population.

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© Copyright 2019 Morressier GmbH.
All rights reserved.