Key result
Prehospital fibrinolysis for ST-elevation acute coronary syndrome decreases time to treatment by approximately 1 hour and yields a 15% relative risk reduction in early mortality versus in-hospital therapy.
Why the study?
Does prehospital fibrinolysis reduce early mortality in patients with ST-elevation acute coronary syndromes compared to in-hospital therapy?
Does prehospital fibrinolysis reduce early mortality in patients with ST-elevation acute coronary syndromes compared to in-hospital therapy?
Effect estimate: 15% relative risk reduction
Prehospital fibrinolysis significantly reduces time to treatment and early mortality in STEMI patients compared to in-hospital administration.
May support prehospital fibrinolysis where transport delays persist; extends review evidence but leaves open contemporary randomized confirmation.
Reperfusion therapy for ST-elevation acute coronary syndromes aims at early and complete recanalization of the infarct-related artery to salvage myocardium and improve both early and late clinical outcomes. Prehospital diagnosis of ST-elevation acute coronary syndrome can be made by electrocardiography with or without transtelephonic transmission, and subsequent fibrinolytic therapy can be instituted at home or in the ambulance. Prehospital fibrinolysis decreases time to treatment by approximately 1 hour compared with in-hospital therapy resulting in a significant 15% relative risk reduction in early mortality. This may compare well with primary angioplasty for ST-elevation acute coronary syndrome, although more studies are necessary.
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Freek W.A. Verheugt (2006) conducted a review in ST-elevation acute coronary syndromes. Prehospital fibrinolysis vs. In-hospital therapy was evaluated on Early mortality (15% relative risk reduction). Prehospital fibrinolysis for ST-elevation acute coronary syndrome decreases time to treatment by approximately 1 hour and yields a 15% relative risk reduction in early mortality versus in-hospital therapy.
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