The role of fibrinolytics in the prehospital treatment of ST-elevation myocardial infarction (STEMI).

Journal Article (Journal Article;Review)

The efficacy of fibrinolytics in the treatment of ST-elevation myocardial infarction is directly related to the time of administration, with the first 2 h after symptom onset seen as a critical period for greatest improvement in cardiovascular parameters and mortality. The American College of Cardiology/American Heart Association recommends a medical contact to treatment time of 30 min for fibrinolysis in patients with ST-elevation myocardial infarction. In selected patients, reperfusion goals may be expedited with prehospital administration of fibrinolytics. In clinical trials, prehospital fibrinolysis markedly reduced the time from symptom onset to treatment, allowed earlier ST-segment resolution, and reduced short- and long-term mortality compared with in-hospital treatment. Prehospital fibrinolysis has become more feasible with the introduction of prehospital 12-lead electrocardiography, improved skills of emergency medical services personnel, improved communication with the Emergency Department, and the advent of bolus fibrinolysis. Rapid and accurate administration of a fibrinolytic is vital for the success of prehospital fibrinolysis.

Full Text

Duke Authors

Cited Authors

  • Sayah, AJ; Roe, MT

Published Date

  • May 2008

Published In

Volume / Issue

  • 34 / 4

Start / End Page

  • 405 - 416

PubMed ID

  • 18164167

International Standard Serial Number (ISSN)

  • 0736-4679

Digital Object Identifier (DOI)

  • 10.1016/j.jemermed.2007.02.068


  • eng

Conference Location

  • United States