Document Detail

The role of fibrinolytics in the prehospital treatment of ST-elevation myocardial infarction (STEMI).
MedLine Citation:
PMID:  18164167     Owner:  NLM     Status:  MEDLINE    
The efficacy of fibrinolytics in the treatment of ST-elevation myocardial infarction is directly related to the time of administration, with the first 2 h after symptom onset seen as a critical period for greatest improvement in cardiovascular parameters and mortality. The American College of Cardiology/American Heart Association recommends a medical contact to treatment time of 30 min for fibrinolysis in patients with ST-elevation myocardial infarction. In selected patients, reperfusion goals may be expedited with prehospital administration of fibrinolytics. In clinical trials, prehospital fibrinolysis markedly reduced the time from symptom onset to treatment, allowed earlier ST-segment resolution, and reduced short- and long-term mortality compared with in-hospital treatment. Prehospital fibrinolysis has become more feasible with the introduction of prehospital 12-lead electrocardiography, improved skills of emergency medical services personnel, improved communication with the Emergency Department, and the advent of bolus fibrinolysis. Rapid and accurate administration of a fibrinolytic is vital for the success of prehospital fibrinolysis.
Assaad J Sayah; Matthew T Roe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2007-12-27
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  34     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  405-16     Citation Subset:  IM    
Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Emergency Medical Services / methods*,  statistics & numerical data
Evidence-Based Medicine
Fibrinolytic Agents / therapeutic use*
Myocardial Infarction / drug therapy*,  mortality,  therapy
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Fibrinolytic Agents

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

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