Document Detail

Prospective evaluation of eligibility for thrombolytic therapy in acute myocardial infarction.
MedLine Citation:
PMID:  8664716     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine the proportion of patients presenting with acute myocardial infarction who are eligible for thrombolytic therapy. DESIGN: Cohort follow up study. SETTING: The four coronary care units in Auckland, New Zealand. SUBJECTS: All 3014 patients presenting to the units with suspected myocardial infarction in 1993. MAIN OUTCOME MEASURES: Eligibility for reperfusion with thrombolytic therapy (presentation within 12 hours of the onset of ischaemic chest pain with ST elevation > or = 2 mm in leads V1-V3, ST elevation > or = 1 mm in any other two contiguous leads, or new left bundle branch block); proportions of (a) patients eligible for reperfusion and (b) patients with contraindications to thrombolysis; death (including causes); definite myocardial infarction. RESULTS: 948 patients had definite myocardial infarction, 124 probable myocardial infarction, and nine ST elevation but no infarction; 1274 patients had unstable angina and 659 chest pain of other causes. Of patients with definite or probable myocardial infarction, 576 (53.3%) were eligible for reperfusion, 39 had definite contraindications to thrombolysis (risk of bleeding). Hence 49.7% of patients (537/1081) were eligible for thrombolysis and 43.5% (470) received this treatment. Hospital mortality among patients eligible for reperfusion was 11.7% (55/470 cases) among those who received thrombolysis and 17.0% (18/106) among those who did not. CONCLUSIONS: On current criteria about half of patients admitted to coronary care units with definite or probable myocardial infarction are eligible for thrombolytic therapy. Few eligible patients have definite contraindications to thrombolytic therapy. Mortality for all community admissions for myocardial infarction remains high.
J K French; B F Williams; H H Hart; S Wyatt; J E Poole; C Ingram; C J Ellis; M G Williams; H D White
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  312     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-08-07     Completed Date:  1996-08-07     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1637-41     Citation Subset:  AIM; IM    
Coronary Care Unit, Green Lane Hospital, Auckland, New Zealand.
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MeSH Terms
Age Factors
Coronary Care Units
Follow-Up Studies
Middle Aged
Myocardial Infarction / drug therapy*,  mortality,  physiopathology
New Zealand
Patient Selection*
Thrombolytic Therapy / contraindications,  utilization*
Comment In:
BMJ. 1996 Oct 12;313(7062):941   [PMID:  8876109 ]

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

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