Prehospital thrombolysis: Beneficial effects of very early treatment on infarct size and left ventricular function
Journal of the American College of CardiologyPublished 1 November 1993
Thomas Linderer, Rolf Schröder, R Arntz, Marie-Luise Heineking, Werner Wunderlich, Kathrin Kohl
Citations72
SJR quartileQ1
SJR score9.02
SNIP6.30
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The data suggest that in evolving myocardial infarction up to 4 h in duration, the start of thrombolytic therapy at < or = 1.5 h limits infarct size, preserves left ventricular function and may save lives.
Abstract
The data suggest that in evolving myocardial infarction up to 4 h in duration, the start of thrombolytic therapy at 1.5 h limits infarct size, preserves left ventricular function and may save lives.
Keywords
Medicine
PubMedRandomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group.
2,873 Citations1988R B Sleight, Peter Sleight +4 more
The LancetEFFECTIVENESS OF INTRAVENOUS THROMBOLYTIC TREATMENT IN ACUTE MYOCARDIAL INFARCTION
2,451 Citations1986GRUPPOITALIANOPERLOSTUDIODELL
The LancetTRIAL OF TISSUE PLASMINOGEN ACTIVATOR FOR MORTALITY REDUCTION IN ACUTE MYOCARDIAL INFARCTION
1,157 Citations1988Robert G. Wilcox, Carl Olsson +5 more
Subset analysis showed that patients who had a normal electrocardiogram (ECG) at the time of randomisation had a low case fatality rate and rt-PA was associated with a 24.5% relative reduction in 1 month fatality.
New England Journal of MedicineEffect of Captopril on Progressive Ventricular Dilatation after Anterior Myocardial Infarction
1,103 Citations1988Marc A. Pfeffer, Gervasio A. Lamas +3 more
It is indicated that after anterior myocardial infarction, ventricular enlargement is progressive and that captopril may attenuate this process, reduce filling pressures, and improve exercise tolerance.
Journal of the American College of CardiologyRandomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2
729 Citations1988
17,187 patients entering 417 hospitals up to 24 h after the onset of suspected acute myocardial infarction were randomized, with placebo control, between a 1 h intravenous infusion of streptokinase and 1 month of 160 mg/day enteric-coated aspirin.
New England Journal of MedicineA Prospective Trial of Intravenous Streptokinase in Acute Myocardial Infarction (I.S.A.M.)
726 Citations1986The I.S.A.M. Study Group
It is concluded that beginning intravenous streptokinase infusion early after the onset of myocardial infarction limits the size of the infarct regardless of its localization.
New England Journal of MedicineEffect of Intravenous Streptokinase on Left Ventricular Function and Early Survival after Acute Myocardial Infarction
620 Citations1987Harvey D. White, R M Norris +6 more
It is concluded that administration of intravenous streptokinase to patients with a first myocardial infarction results in improved left ventricular function and short-term survival.
Journal of the American College of CardiologyEarly thrombolysis in acute myocardial infarction: Limitation of infarct size and improved survival
504 Citations1986Maarten L. Simoons, Patrick W. Serruys +10 more
New England Journal of MedicinePrevention of Myocardial Damage in Acute Myocardial Ischemia by Early Treatment with Intravenous Streptokinase
377 Citations1985Gideon Koren, Avraham Weiss +9 more
It is concluded that thrombolytic therapy with streptokinase is most effective if given within the first 1.5 hours after the onset of symptoms of acute myocardial infarction.
CirculationIntravenous short-term infusion of streptokinase in acute myocardial infarction.
368 Citations1983Rolf Schröder, G. Biamino +6 more
Journal of the American College of CardiologyMyocardial infarction triage and intervention project—Phase I: Patient characteristics and feasibility of prehospital initiation of thrombolytic therapy
256 Citations1990W. Douglas Weaver, Mickey S. Eisenberg +11 more
Paramedic selection of appropriate patients for potential prehospital initiation of thrombolytic treatment is feasible with use of a directed checklist and cellular-transmitted ECG and saves time and may reduce the extent and complications of infarction compared with results that can be achieved in a hospital setting.
American Heart JournalTime delays in the diagnosis and treatment of acute myocardial infarction: A tale of eight cities Report from the Pre-hospital Study Group and the Cincinnati Heart Project
186 Citations1990Dean J. Kereiakes, W.Douglas Weaver +12 more
The results show that the magnitude of time required to evaluate, transport, and initiate thrombolytic therapy will preclude initiation of treatment to most patients within the first hour of symptoms.
CirculationSignificance of initial ST segment elevation and depression for the management of thrombolytic therapy in acute myocardial infarction. European Cooperative Study Group for Recombinant Tissue-Type Plasminogen Activator.
165 Citations1990Jos L. Willems, Rik Willems +4 more
The present study shows that the magnitude of initial ST elevation and also of reciprocal ST depression in the admission electrocardiogram is valuable for the management and assessment of thrombolytic therapy in patients with acute myocardial infarction.
The LancetDISCREPANCIES BETWEEN THE EFFECTS OF CORONARY REPERFUSION ON SURVIVAL AND LEFT VENTRICULAR FUNCTION
152 Citations1989Frans Van de Werf
Les statistiques de survie a court et long terme et de fonction ventriculaire gauche apres traitement par thrombolyse de l'infarctus aigu montrent que les effets benefiques de the reperfusion coronarienne ne dependent pas seulement de the recuperation du myocarde ischemique.
The American Journal of CardiologyPrehospital thrombolysis in acute myocardial infarction
125 Citations1990Joachim Schofer, Jochen Büttner +9 more
The saving of 45 minutes in the early stage of an acute infarction through prehospital thrombolysis did not appear to be important for salvage of myocardial function.
The American Journal of CardiologyPrehospital use of APSAC: Results of a placebo-controlled study
124 Citations1989A Castaigne, Christian Hervé +9 more
Results from this study indicate that with regard to the diagnosis of acute myocardial infarction, the risk of a wrong diagnosis is low and prehospital administration of APSAC did not induce a delay in arrival to the coronary care unit.
The American Journal of CardiologyThe German multicenter trial of anisoylated plasminogen streptokinase activator complex versus heparin for acute myocardial infarction
120 Citations1988Thomas Meinertz, Wolfgang Kasper +2 more
A multicenter randomized trial of anisoylated plasminogen streptokinase activator complex (APSAC) versus heparin in patients with acute myocardial infarction of less than 4 hours' duration influences prognosis and clinical course in hospital.
Journal of the American College of CardiologyShoulo thrombolytic therapy be administered in the mobile intensive care unit in patients with evolving myocardial infarction? A pilot study
98 Citations1990Arie Roth, Gabriel I. Barbash +9 more
It is concluded that myocardial infarction can be accurately diagnosed and thrombolytic therapy initiated relatively safely during the prehospital phase by the mobile intensive care team, thus instituting a beneficial clinical trend in favor of prehospital throm bolysis.
The American Journal of CardiologyImproved survival but not left ventricular function with early and prehospital treatment with tissue plasminogen activator in acute myocardial infarction
68 Citations1990Gabriel I. Barbash, Arie Roth +12 more
Prehospital initiation of rt-PA appeared to be safe and feasible and resulted in a 40-minute decrease in the time from symptom onset to treatment initiation, which led to a significantly lower short- and long-term mortality.
Journal of the American College of CardiologyInsights derived from the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trials
68 Citations1988Eric J. Topol, Robert M. Califf +3 more
The American Journal of CardiologyImpact of late coronary artery reperfusion on left ventricular function one month after acute myocardial infarction (results from the ISAM study)
55 Citations1989Rolf Schröder, K. L. Neuhaus +4 more
It is confirmed that restoration of adequate flow through an infarct-related coronary artery beyond the time window for actual salvage of ischemic myocardium has a definite beneficial effect on LV function.
HeartEnzyme tests in the evaluation of thrombolysis in acute myocardial infarction.
43 Citations1988C. de Zwaan, George M. Willems +7 more
The assessment of infarct size by measurement of these enzyme activities can also be applied to patients treated with streptokinase, because the enzymes measured in the present study are all equally valid markers of myocardial injury.
HeartA double blind placebo controlled study of early and late administration of recombinant tissue plasminogen activator in acute myocardial infarction.
40 Citations1989A McNeill, S R Cunningham +8 more
Prehospital administration of rt-PA was feasible and significantly reduced the delay before thrombolysis was started, and earlier treatment improved myocardial function in the the infarct area and reduced theinfarct size.
Journal of the American College of CardiologyLessons from the European Cooperative recombinant tissue-type plasminogen activator (rt-PA) versus placebo trial
37 Citations1988Frans Van de Werf
A new European Cooperative Study Group trial of 721 patients has recently found recombinant tissue-type plasminogen activator (rt-PA) to positively affect infarct size, left ventricular function, cardiovascular morbidity and early survival.
European Heart JournalPotential time saving with pre-hospital intervention in acute myocardial infarction
31 Citations1988European Myocardial Infarction Project (E.M.I.P) Sub-Committee*
Based on a pilot study of 2443 patients with suspected myocardial infarction, simple criteria based on chest pain and first ECG finding have been defined to allow selection of out-of-hospital patients for a trial of pre-hospital drug evaluation.
The American Journal of CardiologyEfficiency of a physician-operated mobile intensive care unit for prehospital thrombolysis in acute myocardial infarction
31 Citations1992Hans-Richard Arntz, Richard Stern +2 more
The efficiency of an emergency medical system for routinely performed prehospital thrombolysis is evaluated for 1 of the 7 physician-staffed mobile intensive care units (MICU) in former West Berlin.
The American Journal of CardiologyFactors affecting outcome of coronary reperfusion with intracoronary streptokinase in acute myocardial infarction
18 Citations1987Richard W. Smalling, Francisco Fuentes +6 more
Patients older than 65 years showed little improvement in 1-year mortality risk and no significant improvement in LV function during hospitalization after treatment with intracoronary SK, and reperfusion success was associated with improved survival and LV function.
Journal of the American College of CardiologyTissue plasminogen activator: why the backlash?
17 Citations1989Eric J. Topol, Robert M. Califf
European Heart JournalControversial indications: Rationale for thrombolysis: later than 4-6 h from symptom onset, and in patients with smaller myocardial infarctions
13 Citations1990Rolf Schröder, T. Linderer +5 more
It would be unwarranted to withhold thrombolytic therapy from patients with smaller sigma ST increases on admission ECG, although weak correlations largely limit the value of sigmaST increases to predict the outcome in an individual patient.
European Heart JournalSympathetic modulation in practice: the German clinical experience
3 Citations1990W. Küpper, Hans-Hermann Erlemeier +1 more
This overview demonstrated a 2.98 +/- 0.68 kJ improvement in work done over placebo, equivalent to 14% (xamoterol) and 6% (placebo) improvements over baseline, which is thus a promising new approach to the treatment of mild to moderate heart failure.
DMW - Deutsche Medizinische WochenschriftPräklinische Thrombolyse bei akutem Myokardinfarkt
3 Citations2008T. Linderer, H.-R. Arntz +1 more
