Fibrinolytic therapy in young women with acute myocardial infarction

Study objective: Previous studies found that women with acute myocardial in farction (AMI) receive less aggressive therapy compared with men. We sought to determine the percentage of young women (less than or equal to 50 years ) with an AMI eligible for fibrinolytic therapy who received it and explore factors resulting in the ineligibility of women for fibrinolytic therapy. Methods: A retrospective chart review was conducted far women 50 years of a ge or younger who were discharged from a tertiary cardiac care hospital wit h a diagnosis of AMI during the period 1990 to 1995. Women were included if they met the World Health Organization criteria for AMI. Results: There were 126 women meeting inclusion criteria with 54 (43%) rece iving fibrinolytic therapy. Sufficient information to determine eligibility for fibrinolytic therapy was available for 118 (94%) of the women. Forty-o ne (91%) of the 45 women who met eligibility criteria received fibrinolytic therapy. Of the 73 women who were ineligible for fibrinolytic therapy, 52 (71%) had a nondiagnostic EGG, 28 (38%) presented 12 hours after symptom on set, and 19(26%) had an absolute or relative contraindication to fibrinolyt ic therapy. Of the women not meeting eligibility requirements, 15% nonethel ess received fibrinolytic therapy. Conclusion: In this study, most young women with AMI who were eligible for fibrinolytic therapy received it. Nondiagnostic ECG and late presentation t o the emergency department (>12 hours after symptom onset) were the most co mmon reasons for ineligibility.