[Thrombolytic treatment in acute myocardial infarction. Choice of preparations in Norwegian hospitals].
In 1994 Statens legemiddelkontroll recommended Norwegian hospitals to increase the use of recombinant tissue plasminogen activator (r-tPA) in thrombolytic treatment of acute myocardial infarction. Using a questionnaire, which was distributed to all medical departments in Norwegian hospitals, we examined and assessed the preference of thrombolytic agents. None of the coronary care units administered r-tPA routinely as their first choice. Of 59 hospitals involved, 35 (59%) considered r-tPA on a wider indication (i.e. young age, short history of symptoms, and anterior wall infarction) than the 24 (41%) that only used r-tPA when streptokinase had recently been given. Of a total of 11,191 cases of myocardial infarction in 1996, 628 (6%) were treated with r-tPA. Closer examination of 2,818 cases of myocardial infarction in 13 hospitals revealed that thrombolytic treatment was given in 1,016 (36%) instances. In 206 cases (20%), the chosen agent was r-tPA, whereas 810 (80%) were given streptokinase. The reasons for the preference of streptokinase to r-tPA are discussed.
Medisinsk avdeling B, Rikshospitalet, Oslo.
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Andreassen
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Gullestad
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Endresen
D016507:Cardiology Service, Hospital; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D009664:Norway; D010818:Practice Patterns, Physicians'; D013300:Streptokinase / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
D005343:Fibrinolytic Agents; D013300:Streptokinase; D010959:Tissue Plasminogen Activator