Abstract
Although thrombolytic therapy has clearly become the standard of care for acute myocardial infarction (AMI), its delivery in Canada continues to be extremely variable. Significant unnecessary delays in the initiation of this treatment still occur in many hospitals and constitute the most common avoidable cause of death in patients with AMI. The authors agree with the statement by representatives of the member organizations of the Emergency Cardiac Care Coalition (see pages 483 to 487 of this issue) that emergency service providers must get patients to hospital sooner and that all eligible patients should receive thrombolytic therapy within 30 minutes of their arrival at hospital. This objective requires that thrombolytic therapy be initiated by emergency physicians and be supported by well-established guidelines for its use.
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Selected References
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- Birkhead J. S. Time delays in provision of thrombolytic treatment in six district hospitals. Joint Audit Committee of the British Cardiac Society and a Cardiology Committee of Royal College of Physicians of London. BMJ. 1992 Aug 22;305(6851):445–448. doi: 10.1136/bmj.305.6851.445. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dracup K., Moser D. K. Treatment-seeking behavior among those with signs and symptoms of acute myocardial infarction. Heart Lung. 1991 Sep;20(5 Pt 2):570–575. [PubMed] [Google Scholar]
- Gonzalez E. R., Jones L. A., Ornato J. P., Bleecker G. C., Strauss M. J. Hospital delays and problems with thrombolytic administration in patients receiving thrombolytic therapy: a multicenter prospective assessment. Virginia Thrombolytic Study Group. Ann Emerg Med. 1992 Oct;21(10):1215–1221. doi: 10.1016/s0196-0644(05)81749-4. [DOI] [PubMed] [Google Scholar]
- Kereiakes D. J., Weaver W. D., Anderson J. L., Feldman T., Gibler B., Aufderheide T., Williams D. O., Martin L. H., Anderson L. C., Martin J. S. Time 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. Am Heart J. 1990 Oct;120(4):773–780. doi: 10.1016/0002-8703(90)90192-z. [DOI] [PubMed] [Google Scholar]
- McDonald P. J. Antibiotic guide-lines--do we know where we are going? Med J Aust. 1989 Jun 5;150(11):610–611. doi: 10.5694/j.1326-5377.1989.tb136721.x. [DOI] [PubMed] [Google Scholar]
- Sharkey S. W., Bruneete D. D., Ruiz E., Hession W. T., Wysham D. G., Goldenberg I. F., Hodges M. An analysis of time delays preceding thrombolysis for acute myocardial infarction. JAMA. 1989 Dec 8;262(22):3171–3174. [PubMed] [Google Scholar]
- Weaver W. D., Cerqueira M., Hallstrom A. P., Litwin P. E., Martin J. S., Kudenchuk P. J., Eisenberg M. Prehospital-initiated vs hospital-initiated thrombolytic therapy. The Myocardial Infarction Triage and Intervention Trial. JAMA. 1993 Sep 8;270(10):1211–1216. [PubMed] [Google Scholar]
- Wielgosz A. T., Nolan R. P., Earp J. A., Biro E., Wielgosz M. B. Reasons for patients' delay in response to symptoms of acute myocardial infarction. CMAJ. 1988 Nov 1;139(9):853–857. [PMC free article] [PubMed] [Google Scholar]