Thrombolytic therapy after cardiac arrest and its effect on neurological outcome.
OBJECTIVE
the aim of the study is to investigate the effect of thrombolytic therapy on neurological outcome in patients after cardiac arrest due to acute myocardial infarction. Laboratory investigations have demonstrated that thrombolytic therapy after cardiopulmonary resuscitation improves neurological function.


METHODS
from July 1991 to June 1996, patients with witnessed ventricular fibrillation cardiac arrest due to acute MI and successful restoration of spontaneous circulation admitted to the emergency department were analyzed retrospectively. A logistic regression model was used to assess the association between thrombolytic therapy and neurological outcome [best cerebral performance category (CPC) within 6 months after cardiac arrest].


RESULTS
all 157 patients [median age 57 years (IQR 50-69)] were analyzed. Thrombolytic therapy was applied in 42 patients (27%). With thrombolytic therapy good functional neurological recovery (CPC 1 or 2) was achieved more frequently (69 vs. 50%, P=0.03). After controlling for age, prehospital dosage of epinephrine, and the duration of cardiac arrest we found a non significant trend towards good neurological recovery when thrombolytic therapy was given (OR 1.9, 95% CI 0.8-4.6).


CONCLUSIONS
thrombolytic therapy after cardiac arrest due to acute myocardial infarction is associated with improved neurological outcome.
Schreiber
W
W
Universitätsklinik für Notfallmedizin, Allgemeines Krankenhaus der Stadt Wien, Währinger Gürtel 18-20/6/D, 1090 Vienna, Austria.
Gabriel
D
D
Sterz
F
F
Muellner
M
M
Kuerkciyan
I
I
Holzer
M
M
Laggner
A N
AN
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology; D016001:Confidence Intervals; D004636:Emergency Service, Hospital; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006323:Heart Arrest / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy
D005343:Fibrinolytic Agents; D006493:Heparin; D001241:Aspirin