Pre-hospital thrombolysis in perspective

Abstract

Aims: To review existing evidence on the role of pre-hospital fibrinolysis in patients with ST-elevation myocardial infarction (MI).

Methods and results: Overview of current guidelines and data from trials and registries on the best perfusion approach for acute MI with ST-elevation. Despite advances in the treatment of ST-elevation MI, the mortality rate before any therapy is administered is high, with half of all fatalities occurring within 2 h of symptom onset. Current treatment options, including the timely use of pre-hospital fibrinolysis, have reduced the overall 1 month mortality. Mortality can be further improved when patient characteristics, risk factors and time delays to treatment are considered.

Conclusion: Time factors are essential in the success of fibrinolysis, and subsequent coronary intervention seems beneficial.