title: Percutaneous coronary intervention or prehospital thrombolysis? What is the preferred treatment in S-T elevation myocardial infarction?
abstract: There is no situation in medicine where outcome is so utterly dependent on time than in the treatment of patients with S-T elevation myocardial infarction. This life-threatening situation accounts for 30% of acute coronary syndromes. Prompt myocardial reperfusion saves lives, but health services need to be thoroughly organised to achieve this outcome. Unfortunately, a minority of patients in Australia present within 2 h of symptom onset and most patients receive reperfusion 3-4 h after. So health professionals begin at a disadvantage. A novel approach to this problem has been to give thrombolysis at first contact with the patient, before admission to hospital. A French study has assessed this practice against the gold standard treatment for S-T elevation myocardial infarction with some very interesting results. The implications of this study now challenge well-entrenched guidelines for the management of patients with this condition.
authors.affiliation: Epworth Hospital, Melbourne, Victoria, Australia. martinhiscock@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Hiscock
mesh_terms: D002986:Clinical Trials as Topic / Q000379:methods; D004632:Emergency Medical Services / Q000379:methods; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome