To the Editor: A review by Harper and Lefkovits favoured increased use of prehospital thrombolysis (PHT) for the management of ST-elevation myocardial infarction (STEMI).1 The acknowledged importance of early reperfusion and the ready application of PHT make this a sound recommendation for settings that are remote from percutaneous coronary intervention (PCI) centres.
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Prehospital thrombolysis for STEMI: a strategy for town and country?
David B Brieger
Med J Aust 2011; 195 (3): 157-158.
David B Brieger, Head of Coronary Care and Coronary Interventions
Harper RW, Lefkovits J. Prehospital thrombolysis followed by early angiography and percutaneous coronary intervention where appropriate — an underused strategy for the management of STEMI. Med J Aust 2010; 193: 234-237.
Bonnefoy E, Steg PG, Boutite F, et al. Comparison of primary angioplasty and pre-hospital fibrinolysis in acute myocardial infarction (CAPTIM) trial: a 5-year follow-up. Eur Heart J 2009: 30: 1598-1606.
Steg PG, Bonnefoy E, Chabaud S, et al. Impact of time to treatment on mortality after prehospital fibrinolysis or primary angioplasty: data from the CAPTIM randomized clinical trial. Circulation 2003; 108: 2851-2856.
Stenestrand U, Lindbäck J, Wallentin L; RIKS-HIA Registry. Long-term outcome of primary percutaneous coronary intervention vs prehospital and in-hospital thrombolysis for patients with ST-elevation myocardial infarction. JAMA 2006; 296: 1749-1756.
Ellis SG, Tendera M, de Belder MA, et al. Facilitated PCI in patients with ST-elevation myocardial infarction. N Engl J Med 2008; 358: 2205-2217.
Assessment of the Safety and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention (ASSENT-4 PCI) investigators. Primary versus tenecteplase-facilitated percutaneous coronary intervention in patients with ST-segment elevation acute myocardial infarction (ASSENT-4 PCI): randomised trial. Lancet 2006; 367: 569-578.
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