Fibrinolytic therapy and bleeding complications: risk predictors from RIKS-HIA

Heart
Jonas OldgrenRIKS-HIA registry, Sweden

Abstract

Fibrinolytic treatment for ST-elevation myocardial infarction is associated with increased bleeding risk but is still widely used world wide, mainly because of limited access to primary PCI. To analyse contemporary fibrinolytic treatment patterns, in-hospital bleeding risk and prognosis during 2001 to 2006 in unselected Swedish patients. The RIKS-HIA registry covers almost all Swedish patients treated for acute coronary syndromes. Major in-hospital bleeding was defined as lethal or intracranial bleeding or bleeding requiring surgery or blood transfusion. Survival status of the 15 373 patients was obtained from the National Cause of Death Register. The number of patients receiving fibrinolysis as reperfusion therapy decreased from 4336 patients in 2001 to 733 in 2006. Cases of major in-hospital bleeding increased from 1.2% (including 0.7% lethal or intracranial) in 2001 to 4.0% (1.1%) in 2006, p<0.001. Higher age, female gender, hypertension, kidney failure, clopidogrel treatment before admission, pre-hospital administration of fibrinolysis and fibrin-specific fibrinolytic agents were identified as predictors for bleeding. Major in-hospital bleeding was the strongest predictor of adverse prognosis with a more than threefold incr...Continue Reading

Citations

Jan 29, 2014·The Canadian Journal of Cardiology·Mona IzadnegahdarKarin H Humphries
Oct 26, 2013·The American Journal of Medicine·Yutthapong TemtanakitpaisanJason M Konter
Oct 26, 2013·The American Journal of Medicine·Paul D Stein, Fadi Matta
Dec 31, 2011·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·Charles Knight, Adam D Timmis
Oct 10, 2015·European Heart Journal. Acute Cardiovascular Care·Anna HolmJoakim Alfredsson
Mar 23, 2011·European Heart Journal·Jan Steffel, Eugene Braunwald
Nov 14, 2019·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Paul DavisNicholas K Garrett

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