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June 1, 1991QJM

Patency rates (87%), rapid ST segment resolution (95%), and QRS score ≤3 (74%) were statistically significantly higher for those treated in the first hour compared with those treated later.

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Why the study?

Does thrombolytic therapy within 1 hour of symptom onset improve patency rates and ST segment resolution in patients with acute myocardial infarction compared to later treatment?

Population

239 consecutive patients with acute myocardial infarction, including a subgroup of 39 patients treated…

Comparison

Thrombolytic therapy administered within 1 hour… vs Thrombolytic therapy administered later.

Design

Cohort

Authors

AMA McNeillDFDJ FLANNERYCWCM WILSON

Discussion

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Overview

May support prioritizing thrombolysis <1 h; leaves open randomized confirmation on clinical outcomes.

Structured PICO

Does thrombolytic therapy within 1 hour of symptom onset improve patency rates and ST segment resolution in patients with acute myocardial infarction compared to later treatment?

P
Population
239 consecutive patients with acute myocardial infarction, including a subgroup of 39 patients treated within 1 hour (17 anterior, 21 inferior, 1 lateral infarction).
I
Intervention
Thrombolytic therapy (recombinant tissue plasminogen activator or anistreplase) administered within 1 hour (mean 51 minutes, range 20-60 minutes) of symptom onset.
C
Comparator
Thrombolytic therapy administered later (after 1 hour, up to 285 minutes after symptom onset).
O
Outcome
Patency rates, rapid ST segment resolution, and QRS score.surrogate

Administering thrombolytic therapy within one hour of acute myocardial infarction symptom onset significantly improves angiographic patency and ST segment resolution.

Cite This Study

McNeill et al. (1991) studied this question.

synapsesocial.com/papers/6a7da39a6ef7ec97ba7d868dhttps://doi.org/10.1093/oxfordjournals.qjmed.a068569
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Intravenous Thrombolytic Treatment for Acute Myocardial Infarction1988 · 2 citations
  2. 2Prehospital thrombolysis in acute myocardial infarction1998 · 26 citations
  3. 3Thrombolytic Therapy in Acute Myocardial Infarction1989 · 18 citations
  4. 4An Analysis of Time Delays Preceding Thrombolysis for Acute Myocardial Infarction1989 · 166 citations
  5. 5Early thrombolytic treatment in acute coronary thrombosis1993 · 1 citations