Thrombolysis in myocardial infarction

Cobbe, S M

doi:10.1136/bmj.308.6923.216

Cited by 60 publications

(2 citation statements)

References 6 publications

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“…The Remote and Rural Areas Resource Initiative, funded by the National Health Service of Scotland to develop healthcare services and support for professional staff in remote and rural parts of Scotland, has initiated projects to train general practitioners and paramedics in the administration of prehospital thrombolysis. Benefit in prehospital treatment particularly is conferred when people live some distance from the nearest hospital, 33,34 and general practitioners can help in the management of patients with suspected acute myocardial infarction. 35 Having general practitioners who are located more than 30 minutes' traveling time from any hospital provide thrombolysis has been associated with increased survival 36 and has been shown to be cost effective 37 ; methods of motivating general practitioners to do so are needed.…”

Section: Discussionmentioning

confidence: 99%

Urban–Rural Inequalities in Ischemic Heart Disease in Scotland, 1981–1999

Levin

Leyland²

2006

Am J Public Health

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Section: Discussionmentioning

confidence: 99%

Urban–Rural Inequalities in Ischemic Heart Disease in Scotland, 1981–1999

Levin

Leyland²

2006

Am J Public Health

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“…The guidelines go on to recommend that “in localities where transport times to hospital are prolonged, or where delays in hospital are great, general practitioners should take the initiative for thrombolytic treatment.” Other authorities have suggested that thrombolytic treatment should be initiated before the patient is transfered to hospital if travelling time is 30 minutes or more 34…”

Section: Discussionmentioning

confidence: 99%

Call to needle times after acute myocardial infarction in urban and rural areas in northeast Scotland: prospective observational study

Rawles

Sinclair

Jennings

et al. 1998

BMJ

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Objective: To determine call to needle times and consider how best to provide timely thrombolytic treatment for patients with acute myocardial infarction. Design: Prospective observational study. Setting: City, suburban, and country practices referring patients to a single district general hospital in northeast Scotland. Subjects: 1046 patients with suspected acute myocardial infarction given thrombolytic treatment. Main outcome measures: Time from patients' calls for medical help until receipt of opiate or thrombolytic treatment, measured against a call to needle time of 90 minutes or less, as proposed by the British Heart Foundation. Results: General practitioners were the first medical contact in 97% (528/544) of calls by country patients and 68% (340/502) of city and suburban patients. When opiate was given by general practitioners, median call to opiate time was about 30 minutes (95% within 90 minutes) in city, suburbs, and country; call to opiate delay was about 60 minutes in city and suburban patients calling "999" for an ambulance. One third of country patients received thrombolytic treatment from their general practitioners with a median call to thrombolysis time of 45 minutes (93% within 90 minutes); this compares with 150 minutes (5% within 90 minutes) when this treatment was deferred until after hospital admission. In the city and suburbs, no thrombolytic treatment was given outside hospital, and only a minority of patients received it within 90 minutes of calling; median call to thrombolysis time was 95 (46% within 90 minutes) minutes. Conclusions:The first medical contact after acute myocardial infarction is most commonly with a general practitioner. This contact provides the optimum opportunity to give thrombolytic treatment within the British Heart Foundation's guideline.

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Mechanical Reperfusion in Patients With Acute Myocardial Infarction Presenting More Than 12 Hours From Symptom Onset<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>

Schömig¹

2005

JAMA

236

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for the Beyond 12 hours Reperfusion AlternatiVe Evaluation (BRAVE-2) Trial Investigators I N PATIENTS WITH ACUTE STsegment elevation myocardial infarction (STEMI), numerous studies have demonstrated that early reperfusion within 12 hours of symptom onset is associated with increased myocardial salvage, preservation of left ventricular function, and improved survival. 1 Due to time-dependent attenuation of the efficacy of thrombolysis, 2 the application of this reperfusion modal-For editorial comment see p 2930.

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Thrombolysis in myocardial infarction

Cited by 60 publications

References 6 publications

Urban–Rural Inequalities in Ischemic Heart Disease in Scotland, 1981–1999

Urban–Rural Inequalities in Ischemic Heart Disease in Scotland, 1981–1999

Call to needle times after acute myocardial infarction in urban and rural areas in northeast Scotland: prospective observational study

Mechanical Reperfusion in Patients With Acute Myocardial Infarction Presenting More Than 12 Hours From Symptom Onset<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>

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