Pre-hospital factors influencing the time to administration of thrombolytic therapy in acute myocardial infarction in Zagreb region

Journal of Clinical and Basic Cardiology 1998; 1 (1): 30-33

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Keywords: akuter Myokardinfarkt,  präklinische Faktoren,  Thrombolyse,  acute myocardial infarction,  prehospital factors,  thrombolytic therapy

The present study was conducted to examine the possible relationship between various pre-hospital factors and delays in initiation of thrombolytic therapy (TT) in acute myocardial infarction (AMI). Factors analysed were the time of symptom onset to the time of general practitioner (GP) presentation, time of GP presentation to time of hospital admission, geographic location of patients in the Zagreb region, patient?s transportation to the hospital, age and sex of patients. We studied 184 consecutive patients (123 males and 61 females), mean age 63.3 ± 11.4 years, hospitalized for AMI. TT (intravenous Streptokinase) was administered in 42 (23 %) patients. The mean time from symptom onset to GP presentation was 9.7 ± 14.6 hours in patients who did not receive TT, and 1.3 ± 1.3 hours in patients who received TT (p < 0.001). The mean time from GP presentation to hospital admission was 3.2 ± 0.7 hours in patients who did not receive TT and 1.4 ± 0.4 hours in patients who received TT (p < 0.05). The mean time from symptom onset to hospital admission was 12.9 ± 15.3 hours in patients who did not receive TT and 2.7 ± 1.6 hours in patients who received TT (p < 0.001). The patients who received TT were younger (56 versus 63 years), showed a higher male predominance (83 % versus 67 %), and arrived at the GP and at the hospital sooner than those who did not receive TT. The results suggested the time elapsed from the onset of symptoms to GP presentation, time from GP presentation to hospital admission, time necessary for transportation to the hospital for a patient from the Dubrava subregion, younger patients and male sex were important factors influencing the time to administration of TT in AMI. J Clin Basic Cardiol 1998; 1: 30-3.