THROMBOLYSIS IN ACUTE MYOCARDIAL-INFARCTI ON - FACTORS AFFECTING DOOR-TO-NEEDLE TIME

Effect of thrombolytic treatment in acute myocardial infarction depend s on several factors, most importantly on time to treatment. The door- to-needle time, the interval between admission and thrombolytic therap y initiation, may be one important factor. In a retrospective study, w e analysed 151 patients who were admitted to our emergency department with acute myocardial infarction and who received thrombolytic treatme nt. We analysed door-to-needle time with respect to the factors age, g ender, clinical symptoms, presence of prehospital ECG, presence of pre hospital complications, day of admission, hour of admission, duration of pain and infarct site. We observed that the door-to-needle time is significantly shorter in those cases with a prehospital ECG (p < 0.001 ) or no prehospital complications (p < 0.001) as well as inferior infa rction (p < 0.02). There was a trend towards a shorter interval in cas es with typical chest pain plus autonomic symptoms (p = 0.05). No stat istical significance was seen in respect to age, gender, day and hour of admission, and duration of pain. Door-to-needle time with respect t o thrombolytic treatment seems to depend on several factors in the pre clinical field. Improvement of prehospital diagnosis and prevention of preclinical complications might result in faster thrombolytic treatme nt of the patient after arrival at the emergency department.