Richard C. Becker, MD; Joel M. Gore, MD
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To the Editor: We read with interest and concern the recent article by Kase and colleagues (1). During the past several years, plasminogen activators, including recombinant tissue-type plasminogen activator (rt-PA), have revolutionized the treatment of acute myocardial infarction (2, 3). However, because plasmin degrades circulating fibrinogen, factor V, and factor VIII and modifies platelet activity, and because thrombolytic agents are combined frequently with systemic anticoagulants and platelet inhibitors, the risk for hemorrhagic complications, including intracranial hemorrhage, exists. Since June 1984, we have treated over 350 patients with rt-PA and have observed an intracranial hemorrhage rate of less than 1%. In
Becker RC, Gore JM. Tissue Plasminogen Activator and Intracranial Hemorrhage. Ann Intern Med. ;112:630. doi: 10.7326/0003-4819-112-8-630_1
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Published: Ann Intern Med. 1990;112(8):630.
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