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Title: Percutaneous coronary intervention or prehospital thrombolysis? What is the preferred treatment in S-T elevation myocardial infarction?
Epworth Authors: Hiscock, Martin
Keywords: Emergency Medical Services
Myocardial Infarction
Percutaneous Coronary Intervention
S-T Elevation Myocardial Infarction
Acute Coronary Syndrome
Myocardial Reperfusion
Treatment Outcome
Thrombolytic Therapy
Epworth Hospital, Melbourne, Victoria, Australia
Issue Date: Oct-2012
Publisher: Royal Australasian College of Physicians
Citation: Intern Med J. 2012 Oct;42 Suppl 5:44-6
Abstract: There is no situation in medicine where outcome is so utterly dependent on time than in the treatment of patients with S-T elevation myocardial infarction. This life-threatening situation accounts for 30% of acute coronary syndromes. Prompt myocardial reperfusion saves lives, but health services need to be thoroughly organised to achieve this outcome. Unfortunately, a minority of patients in Australia present within 2 h of symptom onset and most patients receive reperfusion 3-4 h after. So health professionals begin at a disadvantage. A novel approach to this problem has been to give thrombolysis at first contact with the patient, before admission to hospital. A French study has assessed this practice against the gold standard treatment for S-T elevation myocardial infarction with some very interesting results. The implications of this study now challenge well-entrenched guidelines for the management of patients with this condition.
DOI: 10.1111/j.1445-5994.2012.02922.x
PubMed URL:
ISSN: 1444-0903
Journal Title: Internal Medicine Journal
Type: Journal Article
Appears in Collections:Cardiac Sciences

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