Document Detail

Thrombolytic therapy for myocardial infarction facilitated by mobile coronary care.
MedLine Citation:
PMID:  15651765     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The benefit of Thrombolytic Therapy (TT) for acute myocardial infarction is time sensitive. In Northern Ireland widespread availability of mobile coronary care units facilitates delivery of TT to heart attack victims. This region-wide prospective observational study assessed the efficacy of various methods of delivery of TT. METHODS: All 15 acute hospitals providing acute coronary care in Northern Ireland participated and data were collected prospectively over six months on all patients admitted with acute myocardial infarction or who received TT. The information was analysed regarding appropriateness of TT, methods and timeliness of delivery of TT and mortality rates. Performance was measured against National Service Framework standards. FINDINGS: Of 1638 patients with acute myocardial infarction 584 were considered eligible for TT and 494 (85 %) received it, in addition to 18 patients without infarction. Of the 512 thrombolysed patients 282 (55%) were treated in hospital coronary care units, 131 (26%) were treated pre-hospital, 97 (19%) in accident and emergency departments, and two in general medical wards. Overall median call-to-needle time was 87 (7-1110) mins and this was shortest for pre-hospital treatment when 55% of call-to-needle times were < or = 60 mins. For patients treated in hospital median door-to-needle time was 46 (0-1065) mins and this was shortest when TT was administered by accident and emergency staff, when 65% of door-to-needle times were < or = 30 mins. In patients with ST elevation myocardial infarction TT was associated with lower mortality, especially when administered pre-hospital. INTERPRETATION: NSF targets for TT are unlikely to be met in Northern Ireland without increasing pre-hospital delivery of TT and by improving collaboration between coronary care and accident and emergency staff with TT availability in accident and emergency departments.
C Wilson; S O'Mullan; M Moore; M McCarthy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Ulster medical journal     Volume:  73     ISSN:  0041-6193     ISO Abbreviation:  Ulster Med J     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2005-01-17     Completed Date:  2005-03-07     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0417367     Medline TA:  Ulster Med J     Country:  Northern Ireland    
Other Details:
Languages:  eng     Pagination:  77-84     Citation Subset:  IM    
Antrim Area Hospital, Antrim BT41 2RL.
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MeSH Terms
Coronary Care Units*
Mobile Health Units*
Myocardial Infarction / drug therapy*
Northern Ireland
Prospective Studies
Thrombolytic Therapy / methods*
Time Factors
Treatment Outcome

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

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