OBJECTIVE To help family physicians who care for patients with acute stroke or who are involved in planning service delivery or resource allocation to understand recent developments in acute stroke care. QUALITY OF EVIDENCE A MEDLINE search indicated that most data were derived from well designed, randomized, double-blind, placebo-controlled trials, including all the largest international stu...

BACKGROUND Multiple clinical trials have provided guidelines for the treatment of myocardial infarction, but there is little documentation as to how consistently their recommendations are being implemented in clinical practice. METHODS AND RESULTS Demographic, procedural, and outcome data from patients with acute myocardial infarction were collected at 1073 US hospitals collaborating in the N...

Patients (n = 533) who participated in the Interuniversity Cardiology Institute of the Netherlands Trial were followed up for 3 to 7 years. The 5 year survival rate after thrombolytic therapy with intracoronary streptokinase was 81% (269 patients) compared with 71% after conventional therapy (264 patients). The greatest improvement in survival was observed in patients with anterior infarction (...

BACKGROUND After an acute myocardial infarction (MI), it is important to define the infarct size because it is related to mortality and morbidity. The Selvester QRS Score is an electrocardiographic (ECG) method that has been developed for estimating MI size. It has been shown to correlate well with postmortem anatomically measured sizes of single MI in patients who did not receive thrombolytic ...

As the population ages the number of elderly patients presenting with acute myocardial infarction (AMI) will continue to increase. There has been no head-to-head trial of thrombolytic therapy versus primary percutaneous coronary intervention (PCI) in this patient cohort, but there is evidence that favors primary PCI. Most elderly patients are candidates for primary PCI, but many have contraindi...

A data base of 1,511 patients admitted to a single Coronary Care Unit was analysed to examine the potential impact of thrombolytic therapy in elderly patients with myocardial infarction. Age was confirmed as a highly significant prognostic factor, and cost utility analysis showed that the cost of thrombolytic therapy with streptokinase in the elderly was lower per quality adjusted life year tha...

Although thrombolytic therapy has been a major advance in the treatment of acute ST-segment elevation myocardial infarction (MI), new thrombolytic agents have been unable to improve early reperfusion. Because aspirin has been shown to be a very effective adjunctive agent in patients with acute MI, it has been hypothesized that the use of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors c...

OBJECTIVE To examine the correlation factors for hemorrhagic transformation after intravenous thrombolytic therapy, so as to improve the forecast about hemorrhagic transformation in the process of thrombolysis, and provide theoretical basis for prognosis of the patients. PATIENTS AND METHODS A total of 1223 patients with intravenous thrombolytic therapy including NIHSS score before intravenou...

Acute myocardial infarction (AMI) evolves as a time-dependent wave front of ischemia when the abrupt rupture of an unstable fatty plaque initiates coronary thrombosis. The prospect of salvaging potentially viable myocardial tissue has led to the development of reperfusion strategies using thrombolytic agents. The efficacy of thrombolytic therapy is determined in large measure by the speed with ...