title: [Intravenous thrombolysis with tissue plasminogen activator (rt-PA) at the prehospital phase of acute myocardial infarction. Apropos of 49 cases].
abstract: In acute myocardial infarction, the earlier intravenous thrombolysis is performed the more effective its action. Pre-hospital intravenous thrombolysis with 100 mg rt-PA was carried out in 49 patients within 3 hours of myocardial infarction. Male preponderance was conspicuous with 44 men (92%) and only 5 women (8%). Mean age was 50.2 +/- 8 years. The infarction was inferior in 48% of the cases. Out of the 49 thrombolyses performed by the mobile intensive care unit, 3 were discontinued on admission (2 diagnostic errors, 1 external heart massage). The time gained by pre-hospital thrombolysis was 52 +/- 25 minutes. There were few complications of thrombolysis: blood effusion at the site of puncture occurred in 4 cases (9%) and haematemesis in 1 case (2%). No cerebral or lethal haemorrhage was observed. Major complications of MI were seldom encountered at the pre-hospital phase: 1 patient died of extensive anterior necrosis with left ventricular dysfunction, and 2 had reversible ventricular fibrillation before treatment was initiated. There was no haemorrhagic complication. The earlier the patient was treated the lower the mortality and morbidity rates. Pre-hospital thrombolysis therefore seems to be feasible when performed by a mobile intensive care unit, and it represents an important gain of time.
authors.affiliation: Service de cardiologie, hôpital Tenon, Paris.
authors.forename: P
authors.initials: P
authors.lastname: Cazaux
authors.forename: G
authors.initials: G
authors.lastname: Leclercq
authors.forename: A
authors.initials: A
authors.lastname: Vahanian
authors.forename: P L
authors.initials: PL
authors.lastname: Michel
authors.forename: J M
authors.initials: JM
authors.lastname: Soulas
authors.forename: P
authors.initials: P
authors.lastname: Barriot
authors.forename: P
authors.initials: P
authors.lastname: Sauval
authors.forename: M
authors.initials: M
authors.lastname: Cupa
authors.forename: C
authors.initials: C
authors.lastname: Lapandry
authors.forename: J
authors.initials: J
authors.lastname: Conard
mesh_terms: D000328:Adult; D000368:Aged; D000552:Ambulances; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005069:Evaluation Studies as Topic; D005260:Female; D005602:France; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D010959:Tissue Plasminogen Activator
vernacular_title: Thrombolyse intraveineuse par l'activateur tissulaire du plasminogène (rt-PA) à la phase préhospitalière dans l'infarctus myocardique aigu. A propos de 49 cas.