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The Pre-Hospital Fibrinolysis Experience in Europe and North America and Implications for Wider Dissemination
McGill Health University Centre.
University College, London.
University of Montreal.
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2011 (English)In: JACC-CARDIOVASCULAR INTERVENTIONS, ISSN 1936-8798, Vol. 4, no 8, 877-883 p.Article in journal (Refereed) Published
Abstract [en]

Objectives The primary objective of this report was to describe the infrastructures and processes of selected European and North American pre-hospital fibrinolysis (PHL) programs. A secondary objective is to report the outcome data of the PHL programs surveyed. less thanbrgreater than less thanbrgreater thanBackground Despite its benefit in reducing mortality in patients with ST-segment elevation myocardial infarction, PHL remained underused in North America. Examination of existing programs may provide insights to help address barriers to the implementation of PHL. less thanbrgreater than less thanbrgreater thanMethods The leading investigators of PHL research projects/national registries were invited to respond to a survey on the organization and outcomes of their affiliated PHL programs. less thanbrgreater than less thanbrgreater thanResults PHL was successfully deployed in a wide range of geographic territories (Europe: France, Sweden, Vienna, England, and Wales; North America: Houston, Edmonton, and Nova Scotia) and was delivered by healthcare professionals of varying expertise. In-hospital major adverse outcomes were rare with mortality of 3% to 6%, reinfarction of 2% to 5%, and stroke of andlt;2%. less thanbrgreater than less thanbrgreater thanConclusions Combining formal protocols for PHL for some patients with direct transportation of others to a percutaneous coronary intervention hospital for primary percutaneous coronary intervention would allow for tailored reperfusion therapy for patients with ST-segment elevation myocardial infarction. Insights from a variety of international settings may promote widespread use of PHL and increase timely coronary reperfusion worldwide.

Place, publisher, year, edition, pages
Elsevier , 2011. Vol. 4, no 8, 877-883 p.
Keyword [en]
acute myocardial infarction, electrocardiogram, fibrinolysis, percutaneous coronary intervention
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-70510DOI: 10.1016/j.jcin.2011.05.013ISI: 000294147500008OAI: diva2:440124
Funding Agencies|Association for the Promotion of Research in Arteriosclerosis, Thrombosis, and Vascular Biology||Aventis||Pfizer||Servier||Caisse Nationale dassurancc-maladie (National Health Insurance system)||Boehringer Ingelheim||AstraZeneca||Sanofi-Aventis||Eli Lilly||Portola||Abbott||Medtronic||Tier 1 Canada Research Chair in Health Services Research||Heart and Stroke Foundation of Ontario||Bristol-Myers Squibb||GlaxoSmithKline||Menarini||Merck-Serono||MSD-Schering-Plough||Merck-Schering-Plough||Novartis||Medicines Company||Available from: 2011-09-12 Created: 2011-09-12 Last updated: 2011-09-12

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Stenestrand, Ulf
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CardiologyFaculty of Health SciencesDepartment of Cardiology UHL
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