Prehospital thrombolysis with rt-PA. A reperfusion strategy in the time management concept of acute myocardial infarction

Patients ann Method: Prehospital thrombolysis was performed on 93 patients during a time period of 6 years (3/1992 to 9/1998) in an urban area. Thromb olysis with rt-PA (20 mg rt-PA bolus, 30 minute infusion with 30 mg rt-PA) could be started within 2 hours after the onset of symptoms in 67 patients (73.6%). Results: The time gain from prehospital thrombolysis amounted to 38 +/- 14 minutes, Bleeding complications were not observed in the prehospital settin g, but 2 patients suffered from intracerebral hemorrhage subsequently and d ied in the hospital, An aborted infarction (CKmax < 200 U/1 and no new Q-wa ves) was observed in 18 patients (20%) and another 23 patients (25%) had a limitation on of infarct size (CKmax < 500 U/1 or no new Q-waves) despite o bvious signs of myocardial ischemia in the first EGG. Conclusion: Our experience demonstrates a considerable time gain for pre-ho spital thrombolysis even for an urban area. Accelerated rt-PA is a safe and comfortable thrombolysis regime.