Circulation, Vol 82, 1140-1146, Copyright © 1990 by American Heart Association
BW Karlson, J Herlitz, N Edvardsson, H Emanuelsson, M Sjolin and A Hjalmarson
Based on the registration of all the 7,157 patients admitted during a
21-month period to the emergency ward of a single hospital in an urban area
with chest pain or other symptoms suggestive of acute myocardial
infarction, we studied eligibility for intravenous thrombolysis in
suspected acute myocardial infarction. We have limited the present analysis
to those 1,715 patients with a strong suspicion of myocardial infarction,
and for these patients, we have calculated the percentages eligible for
thrombolysis when various electrocardiographic and delay time criteria are
applied, but we have not considered contraindications to thrombolysis. We
have also calculated the proportions of all infarctions in this group that
would thereby receive the treatment, and the proportions of patients
treated that would develop a confirmed infarction. Using the criteria ST
elevation on the initial electrocardiogram and arrival in hospital within 6
hours from onset of symptoms, 18% of patients would have been given early
intravenous thrombolysis, 37% of confirmed infarctions would have been
treated, and 91% of all treated patients would have developed a confirmed
infarction; with a delay time criterion of 12 hours, these percentages
would have been 20%, 41%, and 91%, respectively; with a criterion of 24
hours, they would have been 22%, 45%, and 90%, respectively. By not
considering the initial electrocardiogram and applying only the criterion
of delay time, these percentages would have been 70%, 72%, and 45%,
respectively, for a delay time of 6 hours; 83%, 84%, and 45%, respectively,
for a delay time of 12 hours; and 91%, 92%, and 44%, respectively, for a
delay time of 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Eligibility for intravenous thrombolysis in suspected acute myocardial infarction
Department of Medicine I, Sahlgrenska Hospital, Goteborg, Sweden.
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