[Intracranial hemorrhage following thrombolytic therapy in acute myocardial infarct].
BACKGROUND
Intracranial hemorrhage in acute myocardial infarction, under thrombolytic therapeutic, ranges from 0.3 to 3% in different trials. We carried out a study to stabilised the incidence of this complication in ours patients, as well as to analyze its characteristics and asses the presence the predictive factors.


METHODS
We retrospectively reviewed 997 consecutive patients with acute myocardial infarction treated with thrombolytic agents. We used two different protocols in two consecutive periods of time. Protocols differ in the age of the patients, the thrombolytic agent and its interval of applications. We analyze the intracranial hemorrhage incidence rate in each period, as well as its relations with the age of the patients, the sex and the thrombolytic agent used. We also analyze the possible predictive risk factors: cerebral-vascular disease, hypertension, diabetes, etc.


RESULTS
The overall rate of intracranial hemorrhage was 1.6%, higher in the patients of the second period (0.9% vs 1.9%, p = NS). The age over 70 years don't show a significant increase of this incidence (1.7% vs 1.5%). The APSAC group have shown a greater rate of hemorrhage (4%) than streptokinase (0.8%) and rTPA (1.2%). Cerebral-vascular disease and hypertension background were the two factors more frequently related to hemorrhage. The mortality rate was 68.7%.


CONCLUSIONS
The intracranial hemorrhage is a severe complication of thrombolytic therapy with a relative low incidence, but in our experience, higher than described in multicenter studies. There are several factors related that we would to take into account when is applied this therapy.
Torres Martínez
G
G
Unidad Coronaria, Hospital Universitario Virgen de la Arrixaca, Murcia.
Rodríguez García
P
P
Cantón Martínez
A
A
Castillo Soria
F
F
Galcerá Tomás
J
J
García Paredes
T
T
Bru Cartagena
M
M
Jara Pérez
P
P
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013300:Streptokinase / Q000008:administration & dosage / Q000009:adverse effects*; D015912:Thrombolytic Therapy / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects*
D000925:Anticoagulants; D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator
Hemorragia intracraneal tras la terapéutica trombolítica en el infarto agudo de miocardio.