Linked Life Data

9422857

Source:http://linkedlifedata.com/resource/pubmed/id/9422857

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11 Suppl 3
pubmed:dateCreated
1998-2-3
pubmed:abstractText
Twenty years ago, pathophysiologic studies showed that myocardial salvage in acute myocardial infarction depends on early intervention. A meta-analysis of the largest thrombolytic trials showed 1.6 lives saved/1000 treated for each hour closer to symptom onset, and that patients treated in the first hour have a much higher survival rate. The MITI trial found a seven-fold decrease in mortality in patients treated within 70 min of symptom onset. The GUSTO study showed similar results, except that during the first hour mortality was actually higher than in the second hour. In contrast, studies have found that while little survival benefit accrues from treatment after a 12 h delay, significant benefit is achieved by treatment between 6 and 12 h from symptom onset. Thus, mechanisms other than myocardial salvage are at work. A GUSTO substudy demonstrated considerable in-hospital delays in attaining electrocardiographic readings, in deciding on the course of therapy, and most of all in the time to infuse the drug. Other delays in both presentation and treatment are related to patient characteristics such as age, gender, diabetes, and Killip class. The medical community cannot control delays in presentation, but it has been able to reduce in-hospital delays, with resultant benefits in morbidity as well as mortality. At the end of the day, reducing delay outweighs the choice of thrombolytic agent.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
0160-9289
pubmed:author
pubmed:issnType
Print
pubmed:volume
20
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
III11-5
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed:year
1997
pubmed:articleTitle
Clinical outcomes according to time to treatment.
pubmed:affiliation
Chest Pain Unit and Cardiac Care Unit, Duke University Medical Center, Durham, North Carolina 27705, USA.
pubmed:publicationType
Journal Article, Review