XXXX complications of intracoronary fibrinolytic therapy in acute @entity583 . Assessment of risk in a randomised trial.

@entity1 @entity583 @entity548
The risk of @entity548 associated with intracoronary infusion of streptokinase in acute @entity583 was determined in a randomised controlled trial containing 302 @entity1 under the age of 70. Intracoronary streptokinase infusion was given to 152 @entity1 and 150 @entity1 were treated conventionally. @entity548 was seen in 24 (16%) @entity1 in the streptokinase group and in two of the conventionally treated @entity1 . @entity548 was most common (28%) in @entity1 over the age of 60 years. The groin was the site of @entity548 in all @entity1 except one. In the first 48 hours after admission the haematocrit in streptokinase treated @entity1 with @entity548 fell by 0.07 (0.04) (mean (SD)). The fall in haematocrit in the streptokinase treated @entity1 without @entity548 was 0.05 (0.04) and in the conventionally treated @entity1 it fell by 0.03 (0.04). Sixty six units of packed cells were transfused in the streptokinase group (50 units to those who bled); the control group required only 17 units. There were no deaths due to @entity548 . The occurrence of @entity548 and the fall in haematocrit in the streptokinase group correlated with the occurrence of systemic fibrinolysis but not with the dose of streptokinase given. Thus, in about 15% of @entity1 treatment with intracoronary streptokinase resulted in significant @entity548 from the femoral puncture site that required substantial transfusion support. Furthermore, there was a significant drop in haematocrit in @entity1 without @entity548 . These results emphasise the need for more specific fibrinolytic agents.
