| Underuse of thrombolytic therapy in acute myocardial infarction and left bundle branch block. | |
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MedLine Citation:
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PMID: 20155857 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Thrombolytic therapy reduces mortality in patients with acute myocardial infarction (AMI) and left bundle branch block (LBBB). The difficulty in accurately diagnosing AMI in patients with LBBB, however, might result in their undertreatment. Among 3,890 patients hospitalized with chest pain, 241 (6.2%) had LBBB at presentation. The only variable independently associated with AMI among patients with LBBB was in-hospital left ventricular failure (odds ratio [OR]: 4.32, 95% confidence interval [CI]: 1.95-9.57, p < 0.0005). Only 16 (29%) of the LBBB patients with AMI received thrombolytic therapy compared with 583 (78%) of the 747 patients with ST-elevation AMI (p < 0.0005). A further 19 (10%) LBBB patients without AMI also received thrombolysis. Difficulty in making an accurate early diagnosis in patients with LBBB ensures that the majority of those with AMI fail to receive thrombolytic therapy while others without AMI are treated inappropriately. Improved diagnostic and therapeutic strategies are needed for patients with acute coronary syndromes and LBBB. |
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Authors:
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R Andrew Archbold; Kulasegarum Ranjadayalan; Abdel Suliman; Charles J Knight; Andrew Deaner; Adam D Timmis |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical cardiology Volume: 33 ISSN: 1932-8737 ISO Abbreviation: Clin Cardiol Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: E25-9 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 Wiley Periodicals, Inc. |
Affiliation:
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Department of Cardiology, Newham University Hospital, London, UK. andrew.archbold@bartsandthelondon.nhs.uk |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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