• C Firanescu, R Wilbers, and J G Meeder.
• Neth Heart J. 2005 Sep 1; 13 (9): 300-304.

Background/ObjectivesThe purpose of this observational study was to provide an impression of the outcomes of prehospital thrombolysis in combination with an active coronary angioplasty intervention (PCI) strategy for acute ST-elevation myocardial infarction.MethodsIn a group of 151 consecutive patients the following parameters were measured: time delay, percentage of reperfusion, reocclusion, stroke, death, need for PCI and the number of protocol violations.ResultsThe diagnosis by the ambulance paramedics was made in 8±6 minutes, followed by thrombolysis in 13±7 minutes (median±SD). In 2% (3) of the patients the thrombolytic agent was erroneously administered without complications. The elapsed time from onset of symptoms to treatment was a median of 112±77 minutes. Five percent (7) of the patients died in the first 30 days and 2% (3) suffered an intracerebral haemorrhage. Reperfusion was documented in 76% (112) of the patients, from which 18% (20) reoccluded in the following 24 hours. In patients where reperfusion was not established or reocclusion occurred, patients underwent rescue/facilitated PCI: in total 37% (55 patients). After three months 9% (13) of the patients had severly impaired (EF <40%) left ventricular function.ConclusionIn our region, we successfully implemented the prehospital thrombolysis system achieving a competitive call-to-needle time and reperfusion rate. The percentage of patients who violated the protocol, suffered an intracerebral haemorrhage, died and/or had severely impaired left ventricular function was acceptable.

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