[Thrombolytic therapy in acute myocardial infarct: the reasons for ineligibility].
OBJECTIVE
to establish the reasons of ineligibility for thrombolytic therapy (TL) in a group of patients with acute myocardial infarction (AMI).


METHODS
retrospective analysis of protocols and clinical records.


METHODS
the medical intensive care unit (ICU) of a tertiary care hospital.


METHODS
we studied the records from patients with AMI admitted to the ICU during a five-year period (1987-91) and excluded from TL, to determine the cause(s) of ineligibility.


RESULTS
we found 1669 patients with AMI, 89 of which were excluded from the study. Of the remaining 1580 patients, 1274 (80.6%) did not receive TL. Mean age was 64.4 years; 66.4% were men. Mortality was 24.6%. Mean duration of chest pain was 19.4 hours. Chief reasons for exclusion from TL were advanced age (43.1% of patients) and delayed presentation (55.7%); one of these was present in 79.2%.


CONCLUSIONS
this study confirmed the high mortality of patients with AMI who do not receive TL. Advanced age and delayed presentation were the main causes of ineligibility. As age is being abandoned as an exclusion criterion, efforts for expansion of TL should center on the earlier arrival of patients to centers where it is available.
de Jesus
M B
MB
Serviço 2, Hospital de São José, Lisboa.
Sá
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D011174:Portugal / Q000453:epidemiology; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data
Terapêutica trombolítica no enfarte agudo do miocárdio: motivos de inelegibilidade.