Skip to main content
NCBI home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1998 Jul;74(873):405–407. doi: 10.1136/pgmj.74.873.405

Time delay to thrombolytic therapy--a Sri Lankan perspective.

G R Constantine 1, P N Thenabadu 1
PMCID: PMC2360974  PMID: 9799911

Abstract

Reducing the time delay in initiating thrombolytic therapy in acute myocardial infarction is critical in maximising the functional and survival benefit. We analysed 120 consecutive admissions for thrombolytic therapy to the Coronary Care Unit. The total delay was divided into prehospital, in-hospital and Coronary Care Unit stages, and the median delays were found to be 130, 70, and 15 minutes, respectively. The delay was significantly longer in patients who sought prehospital medical advice, and when the diagnosis was not made at the emergency treatment unit. Educating at-risk groups and modifying the admission system may help to minimise these delays, while the establishment of an emergency ambulance service with well-trained crew would also improve the prognosis after acute myocardial infarction in Sri Lanka.

Full text

PDF
405

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. Constantine G. R., Thenabadu P. N. Use of aspirin in ischaemic heart disease. Ceylon Med J. 1996 Dec;41(4):167–168. [PubMed] [Google Scholar]
  3. Dracup K., Moser D. K., Eisenberg M., Meischke H., Alonzo A. A., Braslow A. Causes of delay in seeking treatment for heart attack symptoms. Soc Sci Med. 1995 Feb;40(3):379–392. doi: 10.1016/0277-9536(94)00278-2. [DOI] [PubMed] [Google Scholar]
  4. Gray D., Keating N. A., Murdock J., Skene A. M., Hampton J. R. Impact of hospital thrombolysis policy on out-of-hospital response to suspected myocardial infarction. Lancet. 1993 Mar 13;341(8846):654–657. doi: 10.1016/0140-6736(93)90420-l. [DOI] [PubMed] [Google Scholar]
  5. Greenberg H., Sherrid M. V., Lynn S., Dwyer E. M., Jr, O'Kelly J., Marsella R., Mathesen D. Out-of-hospital, paramedic administered streptokinase for acute myocardial infarction. Lancet. 1988 Nov 19;2(8621):1187–1187. doi: 10.1016/s0140-6736(88)90248-6. [DOI] [PubMed] [Google Scholar]
  6. Herlitz J., Hartford M., Blohm M., Karlson B. W., Ekström L., Risenfors M., Wennerblom B., Luepker R. V., Holmberg S. Effect of a media campaign on delay times and ambulance use in suspected acute myocardial infarction. Am J Cardiol. 1989 Jul 1;64(1):90–93. doi: 10.1016/0002-9149(89)90659-0. [DOI] [PubMed] [Google Scholar]
  7. 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]
  8. Koren G., Weiss A. T., Hasin Y., Appelbaum D., Welber S., Rozenman Y., Lotan C., Mosseri M., Sapoznikov D., Luria M. H. Prevention of myocardial damage in acute myocardial ischemia by early treatment with intravenous streptokinase. N Engl J Med. 1985 Nov 28;313(22):1384–1389. doi: 10.1056/NEJM198511283132204. [DOI] [PubMed] [Google Scholar]
  9. Pell A. C., Miller H. C., Robertson C. E., Fox K. A. Effect of "fast track" admission for acute myocardial infarction on delay to thrombolysis. BMJ. 1992 Jan 11;304(6819):83–87. doi: 10.1136/bmj.304.6819.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Sherry S. Appraisal of various thrombolytic agents in the treatment of acute myocardial infarction. Am J Med. 1987 Aug 24;83(2A):31–46. doi: 10.1016/0002-9343(87)90885-0. [DOI] [PubMed] [Google Scholar]
  11. Topol E. J., Bates E. R., Walton J. A., Jr, Baumann G., Wolfe S., Maino J., Bayer L., Gorman L., Kline E. M., O'Neill W. W. Community hospital administration of intravenous tissue plasminogen activator in acute myocardial infarction: improved timing, thrombolytic efficacy and ventricular function. J Am Coll Cardiol. 1987 Dec;10(6):1173–1177. doi: 10.1016/s0735-1097(87)80114-6. [DOI] [PubMed] [Google Scholar]
  12. Wennerblom B. Early mortality from ischaemic heart disease and the effect of mobile coronary care. Acta Med Scand Suppl. 1982;667:1–58. [PubMed] [Google Scholar]
  13. Weston C., Fox K. A. Pre-hospital thrombolysis: current status and future prospects. J R Coll Physicians Lond. 1991 Oct;25(4):312–320. [PMC free article] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES