Predictors of Bleeding in ST-segment Elevation Acute Myocardial Infarction Patients With Fibrinolysis Therapy / 中国循环杂志

ABSTRACT

Objectives: To observe the prevalence of bleeding and to explore the independent predictors of bleeding in ST-segment elevation acute myocardial infarction patients with fibrinolysis therapy in China. Methods: From January 2013 to June 2014, 1 568 patients undergoing fibrinolysis in the Chinese Acute Myocardial Infarction Registry (CAMI) were prospectively included. Patients were divided into bleeding group (bleeding after fibrinolysis, n=55) and no bleeding group (without bleeding after fibrinolysis, n=1 513). Logistic regression analysis was performed to define the independent predictors of bleeding. Results: The prevalence of bleeding with fibrinolysis in these patients was 3.5% (55/1 568). The fibrinolysis success rate is 86%. Among them, the rate of intracranial bleeding was 0.6%, and the rate of gastrointestinal bleeding was 1.9%. The fibrinolysis success tended to be higher in patients with bleeding (94.1% vs 85.7%, P=0.0589) ,and the mortality rate was significantly higher in patients with bleeding (20.0% vs 7.1%, P=0.0019) . Logistic regression analysis showed that age≥75 years (OR=2.45, 95%CI:1.10-5.46, P=0.0290) and use of rtPA (HR=3.41, 95%CI:1.48~7.86, P=0.0040) were independent predictors of bleeding after fibrinolysis in this patient cohort. Conclusions: The prevalence of bleeding after fibrinolysis in Chinese STEMI patients is low. Older age and rtPA use are independent predictors of bleeding after fibrinolysis in this patient cohort.