Premium
Percutaneous coronary intervention or prehospital thrombolysis? What is the preferred treatment in S ‐ T elevation myocardial infarction?
Author(s) -
Hiscock M.
Publication year - 2012
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2012.02922.x
Subject(s) - medicine , thrombolysis , myocardial infarction , percutaneous coronary intervention , reperfusion therapy , cardiology , intervention (counseling) , st elevation , acute coronary syndrome , intensive care medicine , emergency medicine , medical emergency , nursing
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 A ustralia 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 F rench 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.