Thrombolytic therapy
Tick Tock
“AMAZING, this is the standard of care for people with heart attacks for the last 10 + years! In 1992 my grandfather was 84 and they gave him TPA (a type of thrombolytic therapy), he died two days later as a result of massive strokes caused by the drugs. If I had known this drug would have increased his mortality by about 80%, I would have obviously refused to allow the doctors/hospital to give it.”
That’s the e-mail I received from an e-Alert reader named Wayne. And after reading the text of the article he sent, I was as angry as he was.
Thrombolytic therapy is a widely used medication that dissolves blood clots in coronary arteries. When administered at the outset of heart attack symptoms it may increase the flow of blood and oxygen to the heart and prevent the death of tissue.
But after studies in recent years have indicated an association between thrombolytic drugs and deaths among elderly patients, a research team headed by doctors from Harvard Medical School decided to take a deeper look. And what they found when they examined the medical records of heart attack patients should cause serious concern for anyone with a heart condition. One of the most basic standard therapies administered for heart attack victims can substantially accelerate their deaths.
They looked at records for 2659 patients, from age 65 to 86. From that abstracted data, they were able to draw these four important conclusions:
- Younger patients benefit from thrombolytics, but patients over 75 are less likely to benefit from the medication.
- Patients over the age of 75 who receive the drug are almost 40 percent more likely to die within 30 days than patients of the same age who don’t receive it.
- Recipients ages 65 to 86 showed a 4% increase in the risk of death for every one-year increase in age compared to non-recipients.
- There seems to be a tendency for doctors to prescribe thrombolytics even to patients who have one or more contraindications to the drug.
If you have cardiovascular problems and especially if you are 75 or older, you should be aware of the contraindications for thrombolytics that likely put you in a high-risk group. Contraindications include: recent trauma or surgery, chronic hypertension, current use of anticoagulants, liver dysfunction, active peptic ulcer, recent head trauma, and active internal bleeding, among others. And you should talk with your doctor to find out what his strategy is with this therapy because the decision to administer the drug must be made quickly at the first signs of heart attack symptoms.
It’s hard to say just how much thrombolytic therapy was associated with death in the elderly when Wayne’s grandfather was prescribed TPA 10 years ago. Today, however, there’s simply no excuse for a doctor not being aware of the risk involved in prescribing thrombolytics to heart attack victims over 75.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
Sources:
“Effectiveness of Thrombolytic Therapy for Acute Myocardial Infarction in the Elderly” Archives of Internal Medicine, 162:5
“Lack of Benefit for Intravenous Thrombolysis in Patients with Myocardial Infarction who are Older than 75 Years” Circulation 101:2239
“Heart Attack Drug ‘Could kill elderly.'” BBC News Online
“Which Patients are Not Likely to Benefit from Clot-Dissolving Drugs After a Heart Attack” Colorado Health Site
“Study Questions Clot-Busting Drug use in Elderly” C Health
Copyright 1997-2002 by Institute of Health Sciences, L.L.C.
