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Incidence of intravenous thrombolytic therapy and fatalities in patients with acute transmural myocardial infarct (Q infarct). A study of observations from 1984 to 1987
Authors:B Alt  W Trost  H P Schuster  B Ehlers  K F Bodmann  F K?hler
Abstract:All patients admitted to the ICU with acute myocardial infarction (MI) were treated by the same protocol since 1984. We report the results in Q-wave-MI of 1987 compared to 1984. Age (67.2 +/- 12.4 vs. 66.8 +/- 11.4 years), sex distribution (70.1% vs. 71.9% male), time elapse between begin of symptoms and admittance to the hospital (15.5 +/- 27.0 vs. 15.0 +/- 32.5 hours) were similar in both years, but the total number of definite Q-MI decreased by 22% from 135 (1984) to 105 (1987). Inhospital mortality (20% vs. 23%) and ICU mortality (14% vs. 20%) tended to decrease, although differences did not reach statistical significance. This was paralleled by an increase in the rate of i.v. thrombolytic therapy from 17% (1984) to 28% (1987) of all patients with Q-MI. The percentage of patients who definitely received i.v. thrombolysis when all indication criteria were present and all contraindicatory factors excluded increased from 47% (1984) to 97% (1987). We conclude, that the performance of i.v. thrombolysis in all patients, who fulfill the general accepted criteria for thrombolysis may improve clinical course and outcome in a given population of patients with acute Q-wave-infarction.
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