[Intravenous thrombolysis with tissue plasminogen activator (rt-PA) at the prehospital phase of acute myocardial infarction. Apropos of 49 cases].
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.
Cazaux
P
P
Service de cardiologie, hôpital Tenon, Paris.
Leclercq
G
G
Vahanian
A
A
Michel
P L
PL
Soulas
J M
JM
Barriot
P
P
Sauval
P
P
Cupa
M
M
Lapandry
C
C
Conard
J
J
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*
D010959:Tissue Plasminogen Activator
Thrombolyse intraveineuse par l'activateur tissulaire du plasminogène (rt-PA) à la phase préhospitalière dans l'infarctus myocardique aigu. A propos de 49 cas.