TY - JOUR
T1 - Improved survival but not left ventricular function with early and prehospital treatment with tissue plasminogen activator in acute myocardial infarction
AU - Barbash, Gabriel I.
AU - Roth, Arie
AU - Hod, Hanoch
AU - Miller, Hilton I.
AU - Modan, Michaela
AU - Rath, Shemuel
AU - Zahav, Yedahel Har
AU - Shachar, Amir
AU - Basan, Shemuel
AU - Battler, Alexander
AU - Rabinowitz, Babeth
AU - Kaplinsky, Elieser
AU - Seligsohn, Uri
AU - Laniado, Shlomo
PY - 1990/8/1
Y1 - 1990/8/1
N2 - One hundred ninety patients with acute myocardial infarction (AMI) were treated with recombinant tissue-type plasminogen activator (rt-PA) 2.0 ± 0.8 hours after the onset of symptoms. Eighty-seven patients were enrolled via mobile intensive care units and 103 through the emergency ward. Patients who were enrolled via the mobile intensive care units were randomized to immediate, prehospital treatment initiation, or to delayed, in-hospital treatment initiation. All 190 patients except 2 underwent delayed coronary angiography and, when indicated, angioplasty at 72 hours after enrollment. Patients treated within 2 hours and those treated 2 to 4 hours after symptom onset had similar preservation of left ventricular function, and similar prevalence of congestive heart failure at discharge. Patients treated within 2 hours of symptom onset had significantly lower short- (0.0 vs 6.3%, p = 0.01) and long-term (1.0 vs 9.5%, p = 0.03) mortality. Prehospital initiation of rt-PA appeared to be safe and feasible and resulted in a 40-minute decrease in the time from symptom onset to treatment initiation.
AB - One hundred ninety patients with acute myocardial infarction (AMI) were treated with recombinant tissue-type plasminogen activator (rt-PA) 2.0 ± 0.8 hours after the onset of symptoms. Eighty-seven patients were enrolled via mobile intensive care units and 103 through the emergency ward. Patients who were enrolled via the mobile intensive care units were randomized to immediate, prehospital treatment initiation, or to delayed, in-hospital treatment initiation. All 190 patients except 2 underwent delayed coronary angiography and, when indicated, angioplasty at 72 hours after enrollment. Patients treated within 2 hours and those treated 2 to 4 hours after symptom onset had similar preservation of left ventricular function, and similar prevalence of congestive heart failure at discharge. Patients treated within 2 hours of symptom onset had significantly lower short- (0.0 vs 6.3%, p = 0.01) and long-term (1.0 vs 9.5%, p = 0.03) mortality. Prehospital initiation of rt-PA appeared to be safe and feasible and resulted in a 40-minute decrease in the time from symptom onset to treatment initiation.
UR - http://www.scopus.com/inward/record.url?scp=0025338286&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(90)90832-L
DO - 10.1016/0002-9149(90)90832-L
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:0025338286
SN - 0002-9149
VL - 66
SP - 261
EP - 266
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 3
ER -