hrvatski

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

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.

heparin; ulkus; infarkt miokarda; krvarenje; fibrinoliza

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