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January 1, 1986Catheterization and Cardiovascular Diagnosis

Early IV thrombolysis before helicopter transfer is linked to ~96% higher infarct vessel patency.

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Why the study?

Does early initiation of intravenous thrombolytic therapy prior to helicopter transport improve infarct vessel patency and is it safe in patients with evolving myocardial infarction?

Population

150 consecutive patients with acute myocardial infarction transported by helicopter for acute intervention

Comparison

Intravenous thrombolytic therapy initiated prior… vs No thrombolytic therapy prior to transfer

Design

Cohort

Follow-up

Immediate (during transit and upon arrival for angiography)

Key result

Early initiation of intravenous thrombolytic therapy prior to helicopter transfer for acute MI was associated with increased infarct vessel patency (61.8% vs 31.6%; p<0.001).

Authors

ETEric J. TopolAFA.Y. FungEKEva M. Kline

Discussion

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Overview

Supports pre-transfer thrombolysis for higher patency in acute MI; hypothesis-generating and requires randomized confirmation before practice change.

Study Design

Type

Cohort (n=150)

Structured PICO

Does early initiation of intravenous thrombolytic therapy prior to helicopter transport improve infarct vessel patency and is it safe in patients with evolving myocardial infarction?

P
Population
150 consecutive patients with acute myocardial infarction transported by helicopter for acute intervention.
E
Exposure
Intravenous thrombolytic therapy (tissue plasminogen activator or streptokinase) initiated prior to helicopter transfer
C
Comparator
No thrombolytic therapy prior to transfer
O
Outcome
Safety during transfer (death, bleeding, hemodynamic instability, and arrhythmias)safety

Main Result

Absolute Event Rate: 61.8% vs 31.6%

p-value: p=<0.001

Helicopter transfer of patients with evolving myocardial infarction is safe, and early out-of-hospital thrombolytic therapy improves infarct vessel patency without causing dangerous transport complications.

Cite This Study

Topol et al. (1986) conducted a cohort in acute myocardial infarction (n=150). Intravenous thrombolytic therapy vs. No thrombolytic therapy was evaluated on Infarct vessel patency on immediate coronary angiography (p=<0.001). Early initiation of intravenous thrombolytic therapy prior to helicopter transfer for acute MI was associated with increased infarct vessel patency (61.8% vs 31.6%; p<0.001).

synapsesocial.com/papers/6aa755c25009de3ee8e57ef4https://doi.org/10.1002/j.1097-0304.1986.tb00003.x
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Also Consider

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

  1. 1Thrombolytic Therapy Within One Hour of the Onset of Acute Myocardial Infarction1991 · 10 citations
  2. 2Pre-hospital thrombolytic therapy with either alteplase or streptokinase1995 · 80 citations
  3. 3Prehospital Thrombolytic Therapy in Patients with Suspected Acute Myocardial Infarction1993 · 418 citations
  4. 4Impact of Intravenous Thrombolysis on Short-term Coronary Revascularization Rates1990 · 22 citations
  5. 5Management Strategies and Outcomes of <scp>ST</scp>‐Segment Elevation Myocardial Infarction Patients Transferred After Receiving Fibrinolytic Therapy in the United States2016 · 6 citations