[Prehospital thrombolysis with rt-PS. Reperfusion strategy in a time management concept of acute myocardial infarct].
METHODS
Prehospital thrombolysis was performed on 93 patients during a time period of 6 years (3/1992 to 9/1998) in an urban area. Thrombolysis with rt-PA (20 mg rt-PA bolus, 30 minute infusion with 30 mg rt-PA) could be started within 2 hours after the onset of symptoms in 67 patients (73.6%).


RESULTS
The time gain from prehospital thrombolysis amounted to 38 +/- 14 minutes. Bleeding complications were not observed in the prehospital setting, but 2 patients suffered from intracerebral hemorrhage subsequently and died in the hospital. An aborted infarction (CKmax < 200 U/l and no new Q-waves) was observed in 18 patients (20%) and another 23 patients (25%) had a limitation of infarct size (CKmax < 500 U/l or no new Q-waves) despite obvious signs of myocardial ischemia in the first ECG.


CONCLUSIONS
Our experience demonstrates a considerable time gain for prehospital thrombolysis even for an urban area. Accelerated rt-PA is a safe and comfortable thrombolysis regime.
Kasper
W
W
St.-Josefs-Hospitals Wiesbaden. Kardio@jahoo.de
Furtwängler
A
A
Martin
U
U
Ott
S
S
Drexler
M
M
D000328:Adult; D000368:Aged; D003328:Coronary Thrombosis / Q000188:drug therapy* / Q000401:mortality; D004632:Emergency Medical Services; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D015996:Survival Rate; D015912:Thrombolytic Therapy; D017748:Time Management; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D014505:Urban Population
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
Prähospitale Thrombolyse mit rt-PA. Eine Reperfusionsstrategie im Zeitmanagementkonzept des akuten Herzinfarkts.