Thrombolytic therapy for acute MI in diabetics with retinopathy
Ocular hemorrhage after thrombolytic therapy for acute MI is rare, yet diabetic retinopathy has been considered a contraindication to thrombolysis without clear evidence of an increased risk for ocular hemorrhage. We evaluated 41,021 GUSTO-I trial patients, with and without diabetes, to better define the risk of ocular hemorrhage in acute MI patients treated with thrombolytic therapy. Twelve patients had ocular hemorrhages. Of 6,011 patients with diabetes, only one had an ocular hemorrhage. These data suggest ocular hemorrhage after thrombolytic therapy is extremely uncommon and diabetic retinopathy should not contraindicate thrombolytic therapy in patients with acute MI.
Mahaffey, KW; Toth, CA; White, HD; Stebbins, AL; Granger, CB; Chatterjee, K
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