Clot dissolving therapy (fibrinolytic therapy) has saved many lives when it is applied fast enough with patients who have a heart attack. In younger patients up to age of 65 to 70 years this method was applied without questioning by the treating physicians.
Several studies have shown that elderly patients have more complications such as strokes, where there can be a brain hemorrhage causing another disaster, namely a stroke from a hemorrhage as a side-effect of the clot dissolving medicine. It’s a case of too much of a good thing overthinning the blood. A new study from Sweden, which was published in the Archives of Internal Medicine on April 29, 2003 (Arch Intern Med 2003;163:965-971) showed that elderly patients with a heart attack can also benefit from this clot dissolving therapy. The main investigators, Drs. Ulf Stenestrand and Lars Wallentin, have followed 6,891 patients who have sustained their heart attacks between 1995 and 1999. They were at least 75 years of age and older, but not older than 85 years. Of these patients 3,897 received fibrinolytic therapy and 2,994 did not. Combined survival statistics and statistics of whether or not the patients suffered a stroke as a result of the clot dissolving therapy were recorded over the next year.
There was a drop of 13% of deaths and of strokes in the treatment group when compared to the controls. There were some other ways that the investigators analyzed the data statistically, but the treatment group was always better off.
The investigators concluded that there is no reason to withhold this clot dissolving treatment from elderly patients as the practice had been up to then. Until randomized studies with more details can be done, they stated, one should treat elderly patients who have acute heart attacks until the age of 85 with clot dissolving treatments.
Here are some links that may be of interest:
This link explains what a heart attack is.
Last edited December 9, 2012