12 THERAPY Women's risk of complications with thrombolytics after MI Women who received thrombolytic therapy for treatment of acute myocardial infarction (MI) were at greater risk for fatal and nonfatal complications than men, in the multinational GUSTO-I* study. The controlled, multi centre trial involved 10 315 women and 30 706 men with acute MI who were randomised to receive 1 of 4 thrombolytic regimens. ** The GUSTO-I trial found that the benefit of adding alteplase to streptokinase therapy was similar in men and women in this indication. Interestingly, the final trial data also demonstrated that the overall unadjusted mortality rate was twice as high in women; after adjustment for age, presence of diabetes mellitus, infarct location, HR, BP, bodyweight and height, women still had a 15% higher risk for death than men. The study authors point out that the higher mortality rate may be due to the fact that women who experience MI are usually older than their male counterparts, a characteristic that has been associated with a smaller relative benefit of thrombolytic therapy and a higher risk of stroke. They add that the higher mortality rate seen among women may also be associated with their higher rate of experiencing complications after thrombolytic treatment, such as heart failure and reinfarction. * Global Utilisation of StrepIokinase and tm. for OccILtded C01'O/1/l1)' Aneries-I ** See Inphanna 886: 3-5, 8 May 1993; 800197201 Weaver WD. White liD, Wilcox RG, GUSTO-I Investigators. Comparisons of char.lctcristics and outcomes among women and men with acute myocardial infarction treated with thrombolytic therapy. Journal of the American Medical Association 275: TI7-782, 13 Mar 1996 .... ,..", INPHARMA- 23 Mar 1l1li6 No. 1029 0156-270319611029-000121$01.000 Adlalnternatlonal Limited 1l1li6. All rlghta rnerved

Women’s risk of complications with thrombolytics after MI

Download PDF Report

Upload
dangtuyen
View
212
Download
0

Embed Size (px)

Citation preview

12 THERAPY

Women's risk of complications with thrombolytics after MI

Women who received thrombolytic therapy for treatment of acute myocardial infarction (MI) were at greater risk for fatal and nonfatal complications than men, in the multinational GUSTO-I* study.

The controlled, multi centre trial involved 10 315 women and 30 706 men with acute MI who were randomised to receive 1 of 4 thrombolytic regimens. ** The GUSTO-I trial found that the benefit of adding alteplase to streptokinase therapy was similar in men and women in this indication.

Interestingly, the final trial data also demonstrated that the overall unadjusted mortality rate was twice as high in women; after adjustment for age, presence of diabetes mellitus, infarct location, HR, BP, bodyweight and height, women still had a 15% higher risk for death than men.

The study authors point out that the higher mortality rate may be due to the fact that women who experience MI are usually older than their male counterparts, a characteristic that has been associated with a smaller relative benefit of thrombolytic therapy and a higher risk of stroke. They add that the higher mortality rate seen among women may also be associated with their higher rate of experiencing complications after thrombolytic treatment, such as heart failure and reinfarction. * Global Utilisation of StrepIokinase and tm. for OccILtded C01'O/1/l1)' Aneries-I

** See Inphanna 886: 3-5, 8 May 1993; 800197201 Weaver WD. White liD, Wilcox RG, GUSTO-I Investigators. Comparisons of char.lctcristics and outcomes among women and men with acute myocardial infarction treated with thrombolytic therapy. Journal of the American Medical Association 275: TI7-782, 13 Mar 1996 .... ,..",

INPHARMA- 23 Mar 1l1li6 No. 1029 0156-270319611029-000121$01.000 Adlalnternatlonal Limited 1l1li6. All rlghta rnerved