Elderly Treatment Questioned

Thrombolytic therapy is often used to prevent heart attacks in high-risk patients by dissolving blood-clots. This involves the use of thrombolytic agents such as aspirin. Although recent guidelines have encouraged the adoption of this therapy, a new study shows that thrombolytic therapy may not be as beneficial for patients older than 75 as once thought. This is because as the therapy increases the blood flow to the heart and heightening the oxygen level, the risk of bleeding; thus causing complications, is also increased.

The study is based more than 2,600 heart attack patients who were admitted to the hospital between 1992 and 1996. Researchers from Harvard Medical School collated the records of these patients based on who received thrombolytic therapy, their age and their recovery.

63% of the study group met the criteria required for and received thrombolytic therapy. This group had fewer and less severe problems than the 37% who did not. However, the gravity of the complications increased the older the patient is. The study in particular reports a 4-percent increase in fatality for every one-year increase in age.

While the benefits of thrombolytic therapy in younger patients who meet the criteria for treatment cannot be denied, the concerns about the effects of this treatment on the older population should not be ignored. Even though further studies need to be done on this, in the meantime, researchers advocate the reassessment of thrombolytic therapy in older patients.

SOURCE: Archives of Internal Medicine, 2002;161:561-568