OLDER AGE AND ELEVATED BLOOD-PRESSURE ARE RISK-FACTORS FOR INTRACEREBRAL HEMORRHAGE AFTER THROMBOLYSIS

Intracerebral hemorrhage is an important concern after thrombolytic therapy for acute myocardial infarction, but risk factors are controversial. Accordingly, we assessed risk factors in 107 treated patients of whom 4 had intracerebral hemorrhage. Intracerebral hemorrhage occurred at a mean of 25 hours (range 3.5 to 48) after therapy and was fatal in 2 patients. Significant differences were found between patients with and without intracerebral hemorrhage for age (77 +/- 7 vs 62 +/- 11 years, p less-than-or-equal-to 0.01), and initial (161 +/- 23 vs 135 +/- 23 mm Hg, p less-than-or-equal-to 0.03) and maximal (171 +/- 30 vs 146 +/- 20, p less-than-or-equal-to 0.02) systolic blood pressures. Initial and maximal diastolic blood pressures also tended to be higher (101 +/- 25 vs 86 +/- 16, p less-than-or-equal-to 0.07; 104 +/- 24 vs 90 +/- 13, p less-than-or-equal-to 0.06). Differences did not achieve significance for comparisons of gender, height, weight, site of infarction, time to therapy, specific thrombolytic agent used, concomitant therapy, interventions and partial thromboplastin time. It is concluded that age (greater-than-or-equal-to 70 years) and elevated blood pressure (greater-than-or-equal-to 150/95 mm Hg) are important risk factors for intracerebral hemorrhage. The overall balance of benefit and risk of thrombolysis should continue to be assessed by large mortality trials.