Related Experiment Video
Updated: Jul 13, 2026
12:03
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Bleeding after thrombolysis in acute myocardial infarction
H H Erlemeier1, W Zangemeister, L Burmester
1Department of Cardiology, University Hospital Eppendorf, Hamburg, West Germany.
European Heart Journal
|January 1, 1989
Summary
Thrombolytic therapy for acute myocardial infarction is safe, with bleeding complications occurring in only 6.5% of patients. Different thrombolytic regimens showed no significant difference in bleeding risk.
Area of Science:
- Cardiology
- Emergency Medicine
- Pharmacology
Background:
- Acute myocardial infarction (AMI) requires prompt reperfusion therapy.
- Thrombolytic agents are crucial for restoring blood flow in AMI.
- Comparing the safety and efficacy of different thrombolytics is essential.
Purpose of the Study:
- To evaluate bleeding complications associated with different thrombolytic therapies in AMI patients.
- To assess the safety of thrombolytic treatment in elderly patients and those with comorbidities.
- To determine if fibrinogen levels correlate with bleeding risk or vessel patency.
Main Methods:
- A prospective study of 232 consecutive AMI patients.
- Treatment groups received urokinase, streptokinase, or recombinant tissue-type plasminogen activator (rt-PA).
- Bleeding complications within 24 hours were recorded and analyzed.
Main Results:
- Overall bleeding complications occurred in 6.5% of patients; 3% required blood transfusions.
- No significant correlation was found between patient factors (hypertension, diabetes, age, sex, smoking) and bleeding risk.
- Bleeding risk did not differ significantly between urokinase, streptokinase, and rt-PA groups.
Conclusions:
- Thrombolytic therapy is a safe treatment for acute myocardial infarction, regardless of the specific agent used.
- Safety is maintained even in elderly patients and those with controlled hypertension and diabetes.
- Fibrinogen level decrease did not impact bleeding risk or infarct vessel patency.
Related Concept Videos
01:16Clot Retraction and Fibrinolysis
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:30Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
01:28Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...