Prehospital fibrinolysis.
Reperfusion therapy for ST-elevation acute coronary syndromes aims at early and complete recanalization of the infarct-related artery to salvage myocardium and improve both early and late clinical outcomes. Prehospital diagnosis of ST-elevation acute coronary syndrome can be made by electrocardiography with or without transtelephonic transmission, and subsequent fibrinolytic therapy can be instituted at home or in the ambulance. Prehospital fibrinolysis decreases time to treatment by approximately 1 hour compared with in-hospital therapy resulting in a significant 15% relative risk reduction in early mortality. This may compare well with primary angioplasty for ST-elevation acute coronary syndrome, although more studies are necessary.
Verheugt
Freek W A
FW
Heartcenter, Department of Cardiology, University Medical Center St. Radboud, 6525 GA Nijmegen, The Netherlands. f.verheugt@cardio.umcn.nl