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  • Title: [Thrombolysis of acute myocardial infarct: modifying factors of "door-to-needle time"].
    Author: Schreiber W, Brunner M, Hödl W, Müllner M, Kratochwill C, Huber K.
    Journal: Wien Klin Wochenschr; 1994; 106(20):652-5. PubMed ID: 7810148.
    Abstract:
    Effect of thrombolytic treatment in acute myocardial infarction depends on several factors, most importantly on time to treatment. The door-to-needle time, the interval between admission and thrombolytic therapy initiation, may be one important factor. In a retrospective study, we analysed 151 patients who were admitted to our emergency department with acute myocardial infarction and who received thrombolytic treatment. We analysed door-to-needle time with respect to the factors age, gender, clinical symptoms, presence of prehospital ECG, presence of prehospital 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 infarction (p < 0.02). There was a trend towards a shorter interval in cases with typical chest pain plus autonomic symptoms (p = 0.05). No statistical significance was seen in respect to age, gender, day and hour of admission, and duration of pain. Door-to-needle time with respect to thrombolytic treatment seems to depend on several factors in the preclinical field. Improvement of prehospital diagnosis and prevention of preclinical complications might result in faster thrombolytic treatment of the patient after arrival at the emergency department.
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