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European Heart Journal 1990 11(Supplement F):43-47; doi:10.1093/eurheartj/11.suppl_F.43
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Pre-hospital thrombolysis, is it useful?

A. D. Castaigne*,, Ch. Hervé{dagger}, A.-M. Duval-Moulin*, M. Gaillard{ddagger}, J.-L. Dubois-Randé* and D. Lellouche

* Cardiology Department Paris, France
{dagger} SAMU 75, Necker Hôpital Paris, France
{ddagger} SAMU 94, Hôpital Henri Mondor Creteil, Paris, France

Address for correspondence: A. D. Castaigne, Hôpital Henri Mondor, F 94010, Creteil, France

Thrombolytic treatment efficacy is greater when the delay between onset of pain and treatment is short. One way to shorten this delay is to give treatment at home, but one cannot recommend this technique if it has not been demonstrated first, that pre-hospital thrombolysis is feasible and safe, and second, that it is useful.

We have been able to demonstrate that pre-hospital thrombolysis with APSAC is feasible and safe. Our findings are similar to those of other teams using other drugs. Whether pre-hospital thrombolysis is useful has not been adequately assessed; and we consider that first, the benefit of pre-hospital vs in-hospital thrombolysis must be determined, and second, the results of a study involving many centres, with various levels of training, practicing pre-hospital thrombolysis must be examined. Two large scale stdies are currently being performed. One in Seattle, uses left ventricular ejection fraction as the major endpoint, whereas the other, the European Myocardial Infarction Project, (EMIP) is using total mortality. Data currently available indicate that pre-hospital thrombolysis with APSAC is feasible, easy and safe. We hope that we will very soon be able to answer the lost question: is it useful?

Key Words: Thrombolytic therapy • myocardial infarction • emergencies • mobile care unit • APSAC


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