DRUG REACTIONS Women may be at increased risk of heart rupture after thrombolytics Women who receive thrombolytic therapy following a myocardial infarction (MI) may be at increased risk for early heart rupture. according to the results of a US study. 3759 patients with MI were enrolled in the Thrombolysis and Thrombin Inhibition in Myocardial Infarction (TIMI) 9A and 98 trials. All patients received IV aJteplase [t-PAl (maximum dose loomg) over 90 minutes or streptokinase (1.SMU) over 60 minutes followed by aspirin 150--325mg immediately and daily thereafter. They were then randomised to receive either heparin (5OOOU bolus. 1000 or 1300 Ulhour infusion) or desirudin (0.1 or 0.6 mglkg bolus, 0.1 or 0.2 mglkglhour infusion) for at least 96 hours. Overall. 65 (1.7%) cardiac rupture events occurred; all were fatal. Age> 70 years, female gender and a hislory of angina peCloris were all independendy associaled wilh heart ruplure [odds ra li os of 3.77 (95% CI2.0<H;.91). 2.87 (1.44-5.73) and 1. 82 (1.05-3.16), respeclively). Compared wilh palients who survived, those experiencing cardiac rupture received p-blockers and ACE inhibitors less frequenlly during the 96-hour study. The intensity of anticoagulation with heparin or desirudin did not influence the occurrence of heart rupture in the study. Becker RC, Hochman J s, Cannon CP, lbrombolym ond Thrombin Inhibition in Myocordial. Infaraioa 9 Swdy. FI1.Il cardia!: ruprun: amon, patients 1JU1Cd with thrombolytic IgtJIts aad adj.mcti"" tbrombin IIIt1Jonistl. Observations from !be Tbroalbolysll aad l'bromtM lnhibitiotI in M)"X&fdi&I Infaraioa 9 study. JounW of!be AmerieaD CoUe,eofCardiology 33: 479-487. 1999 ...,.,... 21 1nphamIa -' Apr 100II No. 1111

Women may be at increased risk of heart rupture after thrombolytics

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Page 1: Women may be at increased risk of heart rupture after thrombolytics

DRUG REACTIONS Women may be at increased risk of heart rupture after thrombolytics

Women who receive thrombolytic therapy following a myocardial infarction (MI) may be at increased risk for early heart rupture. according to the results of a US study.

3759 patients with MI were enrolled in the Thrombolysis and Thrombin Inhibition in Myocardial Infarction (TIMI) 9A and 98 trials. All patients received IV aJteplase [t-PAl (maximum dose loomg) over 90 minutes or streptokinase (1.SMU) over 60 minutes followed by aspirin 150--325mg immediately and daily thereafter. They were then randomised to receive either heparin (5OOOU bolus. 1000 or 1300 Ulhour infusion) or desirudin (0.1 or 0.6 mglkg bolus, 0.1 or 0.2 mglkglhour infusion) for at least 96 hours.

Overall. 65 (1.7%) cardiac rupture events occurred; all were fatal. Age> 70 years, female gender and a hislory of angina peCloris were all independendy associaled wilh heart ruplure [odds ralios of 3.77 (95% CI2.0<H;.91). 2.87 (1.44-5.73) and 1.82 (1.05-3.16), respeclively).

Compared wilh palients who survived, those experiencing cardiac rupture received p-blockers and ACE inhibitors less frequenlly during the 96-hour study. The intensity of anticoagulation with heparin or desirudin did not influence the occurrence of heart rupture in the study. Becker RC, Hochman Js, Cannon CP, lbrombolym ond Thrombin Inhibition in Myocordial. Infaraioa 9 Swdy. FI1.Il cardia!: ruprun: amon, patients 1JU1Cd with thrombolytic IgtJIts aad adj.mcti"" tbrombin IIIt1Jonistl. Observations from !be Tbroalbolysll aad l'bromtM lnhibitiotI in M)"X&fdi&I Infaraioa 9 study. JounW of!be AmerieaD CoUe,eofCardiology 33: 479-487. ~b 1999 ...,.,...

1nphamIa-' Apr 100II No. 1111