Key result
Reduced-dose prehospital fibrinolysis followed by urgent PCI allows safe transport of STEMI patients to PCI centers and may be superior to transport to non-PCI hospitals for fibrinolysis.
Why the study?
Does prehospital fibrinolytic therapy followed by urgent PCI improve outcomes in patients with STEMI compared to transport to a non-PCI hospital for fibrinolysis?
Does prehospital fibrinolytic therapy followed by urgent PCI improve outcomes in patients with STEMI compared to transport to a non-PCI hospital for fibrinolysis?
Prehospital reduced-dose fibrinolysis followed by urgent PCI may be a superior reperfusion strategy for STEMI patients compared to transport to a non-PCI hospital for fibrinolysis.
Answers are grounded in this paper and cite their sources.
May support prehospital reduced-dose fibrinolysis plus urgent PCI for STEMI; leaves open confirmation in randomized trials.
In patients with ST-segment elevation myocardial infarction (STEMI) the shorter the reperfusion time, the better the outcome is, regardless of the reperfusion method. Effective, early and rapid reperfusion is the most important goal in the treatment of patients with STEMI. In majority cases of STEMI, transport or transfer to a percutaneous coronary intervention (PCI)-capable center will occur, sometimes bypassing the closest hospital facilities that are not PCI centers. The timely optimal reperfusion strategy might be a prehospital initiated pharmacological reperfusion with subsequent PCI. Reduced-dose prehospital fibrinolysis allows safe transport of STEMI patients to PCI centers for urgent culprit artery PCI, and may be a superior approach compared with transporting patients to the closest non-PCI hospital for fibrinolytic therapy. In this review we will discuss the evidence regarding reperfusion strategies in STEMI patients.
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Yeter et al. (2009) conducted a review in ST-segment elevation myocardial infarction (STEMI). Prehospital fibrinolytic therapy followed by urgent PCI vs. Transporting patients to the closest non-PCI hospital for fibrinolytic therapy was evaluated. Reduced-dose prehospital fibrinolysis followed by urgent PCI allows safe transport of STEMI patients to PCI centers and may be superior to transport to non-PCI hospitals for fibrinolysis.
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