title: The primary care physician and thrombolytic therapy for acute myocardial infarction: comparison of intravenous streptokinase in community hospitals and the tertiary referral center.
abstract: From September 1982 through December 1987, 1012 patients were treated with intravenous streptokinase within 6 hours of acute myocardial infarction. Most of them (816/1012, 81 percent) were treated in community hospitals by primary care physicians. The remaining 196 (19 percent) were treated in the referral center, usually by a cardiologist. Cardiac catheterization within 2 days showed an open infarct artery in 87 percent of the community hospital and 83 percent of the referral center patients (P = NS). Predischarge ejection fraction was similar for community hospital and referral center patients (49 percent +/- 14 percent versus 51 percent +/- 14 percent, respectively), and there was a similar rate of bleeding complications (10 percent versus 13 percent, respectively). We conclude that primary physicians can use intravenous streptokinase effectively and safely in the treatment of patients in community hospitals.
authors.affiliation: Prairie Cardiovascular Center, Springfield, IL 62794-9420.
authors.forename: G J
authors.initials: GJ
authors.lastname: Taylor
authors.forename: A
authors.initials: A
authors.lastname: Song
authors.forename: H W
authors.initials: HW
authors.lastname: Moses
authors.forename: D L
authors.initials: DL
authors.lastname: Koester
authors.forename: F L
authors.initials: FL
authors.lastname: Mikell
authors.forename: J T
authors.initials: JT
authors.lastname: Dove
authors.forename: R E
authors.initials: RE
authors.lastname: Katholi
authors.forename: H A
authors.initials: HA
authors.lastname: Wellons
authors.forename: J A
authors.initials: JA
authors.lastname: Schneider
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D006328:Cardiac Catheterization; D002309:Cardiology; D005194:Family Practice; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D013300:Streptokinase / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015996:Survival Rate
chemical_list: D013300:Streptokinase