Open AccessCost and efficacy of intravenous streptokinase plus PTCA for acute myocardial infarction when therapy is initiated in community hospitals
Author(s) -
Leimbach W. N.,
Hagan A. D.,
Vaughan H. L.,
Sonnenschein R. C.,
Mccoy J. D.,
Basta L. L.
Publication year - 1988
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960111102
Subject(s) - medicine , streptokinase , myocardial infarction , coronary care unit , intensive care unit , emergency medicine , anesthesia , cardiology
The costs and clinical results of a thrombolytic therapy protocol using intravenous (IV) streptokinase in small community hospitals prior to emergency transfer for cardiac catheterization for possible percutaneous transluminal coronary angioplasty (PTCA) were prospectively studied in 56 patients with an acute myocardial infarction [Tulsa Heart Center‐Myocardial Infarction Study Team (THC‐MIST) protocol]. Findings were compared to those for 53 similar patients receiving “conventional therapy” during the same study period. The reperfusion rate for IV streptokinase was 63%. Additional emergency PTCA yielded a total reperfusion rate of 95%. Despite emergency cardiac catheterization for all THC‐MIST patients, average hospital charges were not significantly different between the two groups ($20,495 vs. $20,722; THC‐MIST vs. conventional therapy, respectively). Total charges (hospital plus physician fees) were also not significantly different ($22,986 vs. $22,400; THC‐MIST vs. conventional therapy, respectively). Intensive care unit (ICU) days and total hospital stays were significantly less for THC‐MIST patients (3.1 vs. 5.8 ICU days, p<0.05 and 8.8 vs. 12.4 hospital days, p<0.05; THC‐MIST vs. conventional therapy, respectively). Thus initiation of IV streptokinase in community hospitals for acute myocardial infarction with subsequent transfer for possible PTCA can yield high reperfusion rates without significantly increasing health care costs.