Key result
Among 427 admissions for acute myocardial infarction, 32% received thrombolytic therapy, while 68% did not due to contraindications, delayed admission, advanced age, or nondiagnostic ECG changes.
Why the study?
What are the rates and reasons for withholding thrombolytic therapy in patients admitted with acute myocardial infarction?
Observational (n=427)
No
What are the rates and reasons for withholding thrombolytic therapy in patients admitted with acute myocardial infarction?
Absolute Event Rate: 32% vs 68%
A significant proportion of otherwise eligible AMI patients do not receive thrombolytic therapy due to nondiagnostic ECG changes, highlighting the need for improved early diagnostic tools.
High rate of withheld thrombolysis in AMI highlights eligibility barriers; hypothesis-generating for strategies improving timely diagnosis and access.
In order to describe the execution of thrombolytic therapy in acute myocardial infarction (AMI) in a coronary care unit, case records of 427 admissions in 1992 due to definite or possible AMI were reviewed: 32% received thrombolytic therapy while 68% did not because of contraindications, delayed admission, advanced age or nondiagnostic ECG changes. Among cases otherwise eligible for thrombolytic therapy according to the instructions of the department, 32% did not receive thrombolytic treatment solely because of nondiagnostic ECG changes. There is an obvious need for implementation of improved early diagnostic tools in the decision-making of thrombolysis as for instance newer, sensitive biochemical markers and continuous vectocardiography.
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Haastrup et al. (2008) conducted an observational in Acute myocardial infarction (AMI) (n=427). Thrombolytic therapy vs. No thrombolytic therapy was evaluated on Receipt of thrombolytic therapy. Among 427 admissions for acute myocardial infarction, 32% received thrombolytic therapy, while 68% did not due to contraindications, delayed admission, advanced age, or nondiagnostic ECG changes.
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