Prehospital Administration of Aspirin and Nitroglycerin for Patients With Suspected Acute Coronary Syndrome　― A Systematic Review ―

Abstract

symptom onset. 5 Nitroglycerin is similarly widely used for the effective treatment of the chest pain of angina or suspected ACS. Studies conducted before the era of reperfusion therapy reported the effectiveness of nitroglycerin in reducing infarct size and in-hospital mortality in patients with acute myocardial infarction (AMI) who were admitted to the cardiac care unit within 4 h of onset. 6,7 A spirin and nitroglycerin have been recommended as initial drug therapy for acute coronary syndrome (ACS). 1 Current guidelines for ACS recommend that aspirin is given as soon as possible to ACS patients without contraindications. 1-3 Aspirin has been shown to reduce mortality in ACS. 4 Furthermore, its effect has been shown to be greater when administered earlier after

Pretransfer Aspirin Administration and Its Impact on Angiographic Outcomes for Patients with ST-Elevation Myocardial Infarction

“…8,10,11) However, clinical data demonstrating the benefits of pretransfer aspirin use in patients with STEMI before PCI remain lacking. 8,9) In the present study, pretransfer aspirin administration was not directly associated with decreased infarct size and 30-day mortality. It has been shown that prehospital administration of the combination of aspirin and unfractionated heparin was associated with achievement of TIMI-3 flow before PCI compared with in-hospital administration but not with decreased mortality, which is in agreement with the present results.…”

A 7-month-old girl with a suspected air embolism complication during a living-donor liver transplantation procedure: a case report

“…Recent guidelines for acute coronary syndrome recommend administration of nitroglycerin ( 16 ). Timely detection and 2 h of nitroglycerin infusion may have played a role in the successful experience in this case.…”

Executive Summary ― Acute Coronary Syndrome in the Japan Resuscitation Council Guidelines for Resuscitation 2020 ―

“…In the SysRev and the JRC Resuscitation Guidelines 2020, only 1 observational study was analyzed. 22 For the critical outcome of 30-day mortality, as well as the 1-year mortality, 52 of 1,142 patients (4.6%) in the prehospital administration of nitroglycerin group and 71 of 584 (12.2%) in the control group were observed, with 114 of 1,142 (10.0%) in the prehospital administration group and 131 of 584 (22.4%) in the control group. The prehospital administration group had significantly lower 30-day and 1-year mortality than the control group (OR 0.34 [95% CI: 0.24-0.50; P<0.01] and 0.38 [95% CI: 0.29-0.50; P<0.01], respectively).…”

“…In the SysRev and the JRC Resuscitation Guidelines 2020, three observational studies were analyzed. 22 For the critical outcome of 30-day mortality, which 3 observational studies assessed, 93 of 2,193 patients (4.2%) in the prehospital administration of aspirin group and 160 of 2,157 (7.4%) in the control group were observed. For the critical outcome of 1-year mortality, which one observational study assessed, 102 of 995 (10.3%) in the prehospital administration group and 143 of 731 (19.6%) in the control group were observed.…”