Why the study?
Does prehospital thrombolysis followed by early angiography and PCI improve outcomes compared to primary PCI in patients with STEMI?
Does prehospital thrombolysis followed by early angiography and PCI improve outcomes compared to primary PCI in patients with STEMI?
Prehospital thrombolysis followed by early angiography and PCI is an underused strategy that may offer superior or similar outcomes to primary PCI for STEMI patients when administered early.
May support early prehospital thrombolysis in STEMI within 4 hours; leaves open randomized confirmation before practice change.
Prompt myocardial reperfusion, particularly if achieved within 2 hours of the onset of symptoms, improves outcomes in patients with ST-elevation myocardial infarction (STEMI). Recent data suggest that ambulance-administered prehospital thrombolysis, if given within 2 hours of the onset of STEMI, produces superior outcomes to primary percutaneous coronary intervention (PCI); if given within 4 hours, the outcomes are similar. For optimal results after thrombolysis, patients require angiography (and PCI where appropriate) within 24 hours of the event. These developments have major implications for the practice of cardiology and for the organisation of health services in Australia.
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Harper et al. (2010) studied this question.
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