Frequency of use of thrombolytic therapy in acute myocardial infarction in Israel

Solomon Behar, Edward Abinader, Avi Caspi, Daniel David, Michael Flieh, Yaacov Friedman, Hanoch Hod, Elieser Kaplinsky, Yehezkiel Kishon, Natalio Kristal, Shlomo Laniado, Vladimier Markiewicz, Alon Marmor, Abraham Palant, Benyamin Pelled, Leonardo Reisin, Tiberio Rosenfeld, Natan Roguin, Libi Sherf, Babeth RabinowitzZwi Schlesinger, Samuel Sclarovsky, Izhar Zahavi, Monty Zion, Uri Goldbourt

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26 Scopus citations

Abstract

Thrombolysis is now generally accepted as the initial treatment for patients with acute myocardial infarction (AMI). The extent to which this therapy is implemented in daily practice and the reasons for exclusion from thrombolytic therapy among 413 consecutive patients with AMI hospitalized in 18 coronary care units in Israel during a 1-month survey were prospectively investigated. Thrombolytic therapy administered to 145 patients (35%) was given to 38% of men versus 29% of women (p = not significant), to 38% of patients <75 years old compared with 18% of the very elderly (p < 0.005), and more often to patients with a first or anterior AMI (40 and 48%) than to counterparts with recurrent or inferior AMI (23 and 31%, respectively, p < 0.005 for both). The 2 most frequent reasons for excluding patients from thrombolysis were late arrivals to coronary care units (33%) and lack of ST elevation on the admission electrocardiogram (28%). Hospital mortality was 6% in the thrombolytic group versus 20% in patients found ineligible for thrombolysis. The significance of this difference is not clear as treatment was not randomized.

Original languageEnglish
Pages (from-to)1291-1294
Number of pages4
JournalAmerican Journal of Cardiology
Volume68
Issue number13
DOIs
StatePublished - 15 Nov 1991
Externally publishedYes

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