Prehospital thrombolysis followed by early angiography and percutaneous coronary intervention where appropriate - an underused strategy for the management of STEMI.
Prompt myocardial reperfusion, particularly if achieved within 2 hours of the onset of symptoms, improves outcomes in patients with ST-elevation myocardial infarction (STEMI). Recent data suggest that ambulance-administered prehospital thrombolysis, if given within 2 hours of the onset of STEMI, produces superior outcomes to primary percutaneous coronary intervention (PCI); if given within 4 hours, the outcomes are similar. For optimal results after thrombolysis, patients require angiography (and PCI where appropriate) within 24 hours of the event. These developments have major implications for the practice of cardiology and for the organisation of health services in Australia.
Harper
Richard W
RW
MonashHeart, Monash Medical Centre, Southern Health, Melbourne, VIC, Australia. richard.harper@monash.edu
Lefkovits
Jeffrey
J
D000792:Angiography; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000379:methods*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D015912:Thrombolytic Therapy; D013997:Time Factors
D005343:Fibrinolytic Agents