Document Detail


Prehospital thrombolysis in a rural community: short- and long-term survival.
MedLine Citation:
PMID:  1520646     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In order to assess the feasibility and outcome of using prehospital thrombolysis in acute myocardial infarction in a rural community, we performed an open randomized study of patients with symptoms of acute myocardial infarction of less than 6 hours. One hundred and forty-five patients with acute myocardial infarction were allocated to receive IV streptokinase prehospital by means of a mobile coronary care unit (MCCU) (n = 43) or to receive IV streptokinase in hospital (n = 102). The mean delay time to treatment was 138 minutes (MCCU group) and 172 minutes (hospital group) (p less than 0.02). Reperfusion time was 88 minutes for the MCCU group and 92 minutes for the hospital group. Mortality at 14 days was 2.3% for the MCCU group and 11.7% for the hospital group (p less than 0.05). Six month mortality was 4.9% for the MCCU group and 17.3% for the hospital group (p = 0.03). Mortality at 1 year was 6.1% for the MCCU group and 20.0% for the hospital group (p = 0.04). There were no significant adverse events in either treatment group. Thus, prehospital thrombolysis by streptokinase is feasible and allows significant reduction in the delay time to treatment initiation. There are encouraging improvements in both short- and long-term survival with no apparent reduction in safety profile.
Authors:
B McAleer; B Ruane; E Burke; M Cathcart; A Costello; G Dalton; J R Williams; M P Varma
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  6     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-10-09     Completed Date:  1992-10-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  369-72     Citation Subset:  IM    
Affiliation:
Cardiac Unit, Erne Hospital, Enniskillen, Northern Ireland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ambulances
Cardiac Care Facilities*
Coronary Care Units
Female
Humans
Male
Middle Aged
Mobile Health Units*
Myocardial Infarction / drug therapy*,  mortality
Myocardial Reperfusion
Rural Population
Streptokinase / therapeutic use*
Thrombolytic Therapy*
Chemical
Reg. No./Substance:
EC 3.4.-/Streptokinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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