[Pre-hospital thrombolysis]

Too few myocardial infarctions are thrombolysed, and the thrombolytic agent is usually administered too late. This situation can conceivably be improved by educating both physicians and patients, by promoting thrombolysis in all hospitals and by performing thrombolysis before admission. We report here our experience of pre-hospital thrombolysis with Eminase in the Val-de-Marne department. This preliminary study is just a small stone added to the big heap of small series of thrombolysis at home published throughout the world. But while the feasibility of pre-admission thrombolysis has been well demonstrated, its effectiveness remains to be accurately determined. Two studies involving large groups of patients are currently in progress: one in Seattle with the left ventricular function as principal criterion of judgment, the other in Europe (The European Myocardial Infarction Project) with mortality as main criterion of judgment. We must wait for the results of these studies to know whether pre-hospital thrombolysis will become the standard treatment of myocardial infarction and if so, to implement the relevant changes required in health structures.