Incidence and predictors of bleeding after contemporary thrombolytic therapy for myocardial infarction. The Global Utilization of Streptokinase and Tissue Plasminogen activator for Occluded coronary arteries (GUSTO) I Investigators

Circulation
S D BerkowitzR M Califf

Abstract

Although the benefit of thrombolytic therapy in reducing mortality in acute myocardial infarction is well established, the types of bleeding and risk factors for bleeding are less well described in large trials. We analyzed the baseline characteristics, outcomes, and incidence of bleeding by location, severity, and treatment assignment among 41,021 patients in the GUSTO-I trial of thrombolysis for acute myocardial infarction. Of the 40,903 patients for whom there were complete data, 1.2% suffered severe bleeding and 11.4% experienced moderate hemorrhage at a variety of sites. The most common sources of bleeding were procedure related. The thrombolytic regimen was strongly related to the incidence of bleeding; comparatively more bleeding was seen with the therapies of streptokinase plus intravenous heparin and the streptokinase and tissue plasminogen activator plus intravenous heparin combination. In multivariate analysis, the four most powerful independent predictors of hemorrhage were older age, lighter body weight, female sex, and African ancestry; they remained the most important predictors of bleeding when multivariate analysis was performed on patients who did not undergo invasive procedures. The presence of serious hemorr...Continue Reading

References

Dec 15, 1989·Annals of Internal Medicine·D C SaneC S Greenberg
Sep 2, 1993·The New England Journal of Medicine·UNKNOWN GUSTO investigators

❮ Previous
Next ❯

Citations

May 13, 2003·Expert Opinion on Pharmacotherapy·Daniel R GuerraC Michael Gibson
Mar 25, 2008·American Journal of Physiology. Heart and Circulatory Physiology·Eugene F du ToitAmanda Lochner
Aug 8, 2015·Journal of the Royal Army Medical Corps·Iain ParsonsP Rees
Sep 20, 2002·Journal of Interventional Cardiology·Thach NguyenUNKNOWN AHA/ACC Task Force
Jun 9, 2004·Current Cardiology Reports·Susan K Bennett, Rita F Redberg
Aug 13, 2008·Journal of Cardiovascular Medicine·Pow-Li Chia
Aug 8, 2008·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Orieji C Illoh, Kachi Illoh
Apr 26, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gregory Y H LipJohn Camm
Jun 21, 2014·International Journal of Clinical Pharmacy·Ana de Lorenzo-PintoMaría Sanjurjo-Sáez
Apr 11, 2015·The Annals of Pharmacotherapy·Kimberly BrandtJeffrey Quedado
Apr 30, 2015·Therapeutic Advances in Drug Safety·Mitchell J DaleyEvan J Peterson
Jul 26, 2019·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Habibe HezerAyşegül Karalezli
Feb 4, 2009·Journal of Thrombosis and Haemostasis : JTH·F B MayrB Jilma
Aug 28, 2012·European Heart Journal·UNKNOWN Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)Doron Zahger
Aug 15, 2012·Canadian Journal of Physiology and Pharmacology·Petr Ostadal, Bohuslav Ostadal
Jan 1, 2012·Journal of Surgical Case Reports·Rl Harries, Kf Gomez
Aug 1, 2015·Cardiovascular Drugs and Therapy·Amanda J Stolarz, Nancy J Rusch
Feb 14, 2014·Clinical Cardiology·Jacqueline E Tamis-Holland, Patrick O'Gara
Mar 25, 2017·Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco·Haitham M HusseinUNKNOWN VISTA Collaborators
Dec 15, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Daniel P RothschildTerry R Bowers
Sep 5, 2020·Circulation. Cardiovascular Interventions·Pedro Engel GonzalezDharam J Kumbhani
Aug 4, 2005·Expert Review of Cardiovascular Therapy·Michael HaudeRaimund Erbel
Jul 10, 2009·Women's Health·Liliana Grinfeld, Florencia Rolandi
Mar 23, 2017·European Heart Journal. Cardiovascular Pharmacotherapy·J TamargoS Agewall
Jan 25, 2017·Frontiers of Medicine·Melvin E Klegerman
Aug 16, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Junichi IshigamiKunihiro Matsushita
Sep 18, 2001·Clinical Cardiology·C M Gibson, S J Marble
Jul 8, 2019·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Murat Mert AtmacaMehtap Kocaturk
Dec 12, 2001·Blood Reviews·V J Marder
Jul 1, 1999·Clinics in Chest Medicine·G S Francis
Aug 28, 2021·Stroke and Vascular Neurology·Shuya LiUNKNOWN TRACE II investigatiors

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.