Predictors of intracranial hemorrhage with fibrinolytic therapy in unselected community patients: A report from the FASTRAK II project

Thao Huynh, Jafna L. Cox, David Massel, Cheryl Davies, Joseph Hilbe, Wayne Warnica, Paul A. Daly

Résultat de recherche: Articleexamen par les pairs

42 Citations (Scopus)

Résumé

Background Patients at high risk for intracranial hemorrhage (ICH) are generally excluded from thrombolytic trials. Because the frequency and predictors of ICH reported from these studies may not be widely applicable, we sought to examine this matter further in unselected patients with acute myocardial infarction in the community. Methods FASTRAK II is a prospective ongoing registry of acute coronary syndromes involving 111 Canadian hospitals. Trained medical personnel recorded admission, treatment, and discharge data on patients admitted with acute coronary syndromes. Results From January 1, 1998, to December 31, 2000, 12,739 patients received fibrinolytic therapy for acute myocardial infarction. Of these, 146 patients (1.15%) sustained strokes and 82 patients (0.65%) had an ICH. Advanced age, female sex, history of cerebrovascular event, and systolic hypertension on arrival (systolic blood pressure >160 mm Hg) were identified with a multivariate logistic regression model to be important independent risks factors for ICH. Patients receiving streptokinase had a lower risk of ICH. Among the patients at high risk for ICH, the ICH rates remained low, ranging from 0.7% to 1.8%. Conclusion ICH is an infrequent event after fibrinolytic therapy in ST-elevation MI; this low rate supports broad penetration of this therapy. Simple clinical characteristics are useful in predicting the risk of ICH and allow a clinician to individualize the risk-benefit assessment of this therapy.

Langue d'origineEnglish
Pages (de-à)86-91
Nombre de pages6
JournalAmerican Heart Journal
Volume148
Numéro de publication1
DOI
Statut de publicationPublished - juill. 2004
Publié à l'externeOui

Note bibliographique

Funding Information:
Supported in part by a grant from Hoffmann-La Roche Limited.

ASJC Scopus Subject Areas

  • Cardiology and Cardiovascular Medicine

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

Empreinte numérique

Plonger dans les sujets de recherche 'Predictors of intracranial hemorrhage with fibrinolytic therapy in unselected community patients: A report from the FASTRAK II project'. Ensemble, ils forment une empreinte numérique unique.

Citer