liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Fibrinolytic therapy and bleeding complications: risk predictors from RIKS-HIA
Uppsala University.
Uppsala University.
Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
2010 (English)In: HEART, ISSN 1355-6037, Vol. 96, no 18, 1451-1457 p.Article in journal (Refereed) Published
Abstract [en]

Background 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. Objective To analyse contemporary fibrinolytic treatment patterns, in-hospital bleeding risk and prognosis during 2001 to 2006 in unselected Swedish patients. Methods and results 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, pandlt;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 increase in 1-year mortality. Conclusion During 2001 to 2006 the use of fibrinolytic treatment markedly decreased while the incidence of major bleeding complications more than doubled. The latter might in part be explained by increasing use concomitant antiplatelet therapy, pre-hospital treatment and fibrin-specific fibrinolytic agents. Future close monitoring of bleeding complications is warranted, especially when considering the increased use of various combinations of antithrombotic drugs in conjunction with fibrinolysis and the great impact of bleeding on long-term mortality.

Place, publisher, year, edition, pages
BMJ Publishing Group; 1999 , 2010. Vol. 96, no 18, 1451-1457 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-59717DOI: 10.1136/hrt.2009.188243ISI: 000281666900006OAI: diva2:353181
Available from: 2010-09-24 Created: 2010-09-24 Last updated: 2010-09-24

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Stenestrand, Ulf
By organisation
Cardiology Faculty of Health SciencesDepartment of Cardiology
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 22 hits
ReferencesLink to record
Permanent link

Direct link