Risk factors for intracranial bleeding following fibrinolysis for ST elevation myocardial infarction
| *Unfractionated heparin is the recommended anticoagulant, in the following regimen: an intravenous bolus of 60 U/kg (max 4000 U), followed by a 48–72 hour infusion at 12 U/kg/hour (max 1000 U/kg/hour), aPTT monitoring at 3, 6, 12, and 24 hours after start of treatment (target aPTT 50–70 seconds). |
| †Fibrin specific agents like rt-PA and TNK-tPA increase the risk of intracranial haemorrhage by a factor 1.5 to 2 when compared to streptokinase. In the case of TNK-tPA, careful attention should be paid to the weight adjusted dose. |
| CVA, cerebrovascular accident; TIA, transient ischaemic attack. |
|