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In this rather small study, including 121 patients only, 61 receiving rtPA, the authors did not observe any major bleeding complication, suggesting that lower dosage of thrombolytic treatment may have a significant hemodynamic impact without increasing the risk of major bleeding.
No patient suffered a major bleeding complication.
Major bleeding complication rates varied considerably among different agents.
However, the definition of major bleeding complication varied among the studies.
All-cause mortality and major bleeding complication rates were secondary outcome measures.
Conversely, the risk for major bleeding complication was 15% higher for rivaroxaban.
Similar(47)
Local rtPA infusion with, or without continuous heparin was successful for the majority of patients, and was associated with few major bleeding complications.
During treatment, major bleeding complications occurred in 2.8% of the patients in the LMWH arm versus 4% in the OAT arm: no statistically significant difference was observed (p = 0.31).
At 30 days, all patients were free of the primary clinical outcomes defined as a composite of death, myocardial infarction, or repeat target vessel revascularization, and there were no major bleeding complications.
The work leads to the promising concept that it should be possible to develop allosteric inhibitors that reduce clotting, but do not completely eliminate it, thereby avoiding major bleeding complications that beset anticoagulants today.
No major bleeding complications were documented.
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