THE INFLUENCE OF FIBRINOLYTIC AND HEPARIN THERAPY IN ACUTE MYOCARDIAL INFARCTION UPON GASTROINTESTINAL BLEEDING IN PATIENTS WITH ASYMPTOMATIC ULCEROUS DISEASE

Abstract

Summary. 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%; 2=6.389; p=0.011) as well as in patients without ulcerous disease (6.8 vs 2.8%; 2=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.