Format

Send to

Choose Destination
Neth Heart J. 2005 Sep;13(9):300-304.

Safety and feasibility of prehospital thrombolysis in combination with active rescue PCI strategy for acute ST-elevation myocardial infarction.

Abstract

BACKGROUND/OBJECTIVES:

The purpose of this observational study was to provide an impression of the outcomes of prehospital thrombolysis in combination with an active coronary angioplasty intervention (PCI) strategy for acute ST-elevation myocardial infarction.

METHODS:

In a group of 151 consecutive patients the following parameters were measured: time delay, percentage of reperfusion, reocclusion, stroke, death, need for PCI and the number of protocol violations.

RESULTS:

The diagnosis by the ambulance paramedics was made in 8±6 minutes, followed by thrombolysis in 13±7 minutes (median±SD). In 2% (3) of the patients the thrombolytic agent was erroneously administered without complications. The elapsed time from onset of symptoms to treatment was a median of 112±77 minutes. Five percent (7) of the patients died in the first 30 days and 2% (3) suffered an intracerebral haemorrhage. Reperfusion was documented in 76% (112) of the patients, from which 18% (20) reoccluded in the following 24 hours. In patients where reperfusion was not established or reocclusion occurred, patients underwent rescue/facilitated PCI: in total 37% (55 patients). After three months 9% (13) of the patients had severly impaired (EF <40%) left ventricular function.

CONCLUSION:

In our region, we successfully implemented the prehospital thrombolysis system achieving a competitive call-to-needle time and reperfusion rate. The percentage of patients who violated the protocol, suffered an intracerebral haemorrhage, died and/or had severely impaired left ventricular function was acceptable.

KEYWORDS:

active rescue PCI strategy; acute myocardial infarction; facilitated PCI; paramedics; prehospital thrombolysis; rural community

PMID:
25696516
PMCID:
PMC2497264

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center