pre-hospital Thrombolysis Reduces Incidence of Ischemic Heart Failure

摘要

Pre-hospital thrombolysis with a mean gain of one hour compared with in-hospital thrombolysis could improve left ventricular ejection fraction (LVEF) as well as primary angioplasty for acute myocardial infarction (AMI). We compared the benefits on LVEF and in-hospital outcome after pre-hospital thrombolysis versus primary angioplasty in patients with AMI. We conducted a retrospective study including 318 patients with AMI hospitalised in a single center from 1995 to 1999. Patients underwent primary angioplasty (n = 157) or received pre-hos-pital thrombolysis (n = 161) within 6 hours after the onset of chest pain. The two groups were similar in their baseline characteristics. No difference was noted between the 2 groups for LVEF at the hospital discharge. No difference was noted for in-hospital mortality (primary PTCA:2.48 %, pre-hospital thrombolysis:2.54 %). Regarding major adverse cardiac events, the groups were statistically not different. Pre-hospilal thrombolysis prevents ischemic heart failure after AMI as well as primary angioplasty. We could reduce the incidence of ischemic heart failure after AMI by early initiation of reperfusion therapy with pre-hospital thrombolysis.