[The influence of fibrinolytic and heparin therapy in acute myocardial infarction upon gastrointestinal bleeding in patients with asymptomatic ulcerous disease]

Lijec Vjesn. 2009 May-Jun;131(5-6):119-21.
[Article in Croatian]

Abstract

Aim: To determine in patients with asymptomatic ulcerous disease frequency of hemathemesis and melena (H/M) as complications of fibrinolytic and heparin therapy in acute ST-elevation myocardial infarction (STEMI).

Methods: According to heparin and streptokinase therapy, STEMI patients were divided into two groups. Each group consisted of case study subgroup with patients who had asymptomatic ulcerous disease and a control study subgroup with patients who did not have ulcerous disease.

Results: In heparin therapy there was no significant increase of H/M in patients with and without ulcerous disease (3.4% vs 2.8%, n.s.) as well as in fibrinolytic therapy (5.9% vs 6.8%, n.s.). Fibrinolytic therapy causes more H/M in relation to heparin therapy in patients with ulcerous disease (5.9 vs 3.4%; chi2=6.389; p=0.011) as well as in patients without ulcerous disease (6.8 vs 2.8%; chi2=616; p=0.013). In patients with H/M there were insignificantly more women than men (42.4% vs 57.6%, n.s.).

Conclusion: Patients with asymptomatic ulcerous disease can be exposed to fibrinolytic and heparin therapy when treating STEMI without a significant risk to H/M occurrence in relation to patients without ulcerous disease.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Female
  • Gastrointestinal Hemorrhage / chemically induced*
  • Gastrointestinal Hemorrhage / etiology
  • Heparin / adverse effects*
  • Heparin / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Peptic Ulcer / complications*
  • Thrombolytic Therapy / adverse effects*

Substances

  • Anticoagulants
  • Heparin