Predicting the safety of intravenous thrombolysis with Fortelyzin in patients over 60 years of age with ischemic stroke using the THRIVE scale

Objective: to evaluate the prognostic value of the THRIVE scale in patients aged 60 years and older with ischemic stroke (IS) after intravenous thrombolysis with Fortelyzin® (INN/chemical name – recombinant protein containing the amino acid sequence of staphylokinase; SuperGene LLC, Russia) compared to alteplase, based on a retrospective analysis of the results of the FRIDA randomised clinical trial. Material and methods. Patients (n = 336) were randomly assigned to either the Fortelyzin group (n = 168) or the alteplase group (n = 168). There were 124 patients (74 %) aged 60 years or older in the Fortelyzin group and 123 patients (73 %) in the alteplase group, and these patients were included in the analysis presented. Patients aged 60 years and older were also divided into two groups according to their modified Rankin scale (mRS) score on day 90: a group with a good functional outcome (mRS 0–2) and a group with an unfavourable functional outcome (mRS 3–6). The THRIVE scale was used to predict outcomes after treatment with Fortelyzin or alteplase. AUC values were then calculated. AUC ROC values were compared using the DeLong criterion. Results. For all-cause mortality at day 90, the predicted AUC value on the THRIVE scale was 0.8 (0.71–0.9) in the Fortelyzin group and 0.76 (0.66–0.87) in the alteplase group (p = 0.57). For adverse functional outcomes, the AUC value was 0.73 (0.64–0.82) in the Fortelyzin group and 0.79 (0.71–0.87) in the alteplase group (p = 0.36). Conclusion. The study confirmed the high predictive value of the THRIVE scale for predicting mortality and adverse outcomes in patients aged 60 years and older with IS after treatment with Fortelyzin and alteplase.