Why the study?
Does thrombolytic therapy benefit specific subsets of patients presenting with ischaemic chest pain (e.g., elderly, diabetic, post-CPR)?
Does thrombolytic therapy benefit specific subsets of patients presenting with ischaemic chest pain (e.g., elderly, diabetic, post-CPR)?
This review emphasizes that thrombolytic therapy should not be withheld from specific patient subsets, such as the elderly, diabetics, menstruating women, and those post-CPR, who present with eligible ECG findings.
Answers are grounded in this paper and cite their sources.
May broaden thrombolytic eligibility in practice; leaves open definitive RCT confirmation in these subgroups.
The Fibrinolytic Therapy Trialists' Collaborative Group has demonstrated that patients without clear contraindications who present with ischaemic chest pain within 12 hours of the onset of symptoms and who have ST segment elevation or bundle branch block on their electrocardiogram (ECG), will benefit from thrombolytic therapy. Therefore the treatment of patients presenting with ischaemic chest pain is guided by the initial ECG. This paper addresses the question of thrombolytic eligibility in several subsets of patients who may benefit from treatment. It also explores the data which confirm the benefit for patients presenting with an inferior myocardial infarction and for those presenting from six-12 hours after the onset of symptoms. In conclusion, thrombolytic therapy should not be routinely withheld from diabetic or elderly patients, menstruating women and patients who have had cardiopulmonary resuscitation.
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Ellis et al. (1998) studied this question.
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