[Thrombolysis in acute myocardial infarct. Initial experiences in a Swiss university hospital]

Preliminary experience with thrombolytic therapy in patients with acute myocardial infarction and its practicability in a CCU of a Swiss university hospital are presented. Out of 674 patients with a transmural or non-transmural infarction, 72 (11%) have been treated with thrombolytic agents since March 1986. 53 of these patients were included in the "European Cooperative Study Group" multicenter trial and treated with recombinant tissue plasminogen activator (rt-PA) or placebo; the other 19 patients received streptokinase i.v. with the same inclusion/exclusion criteria. The results corresponded to the well known effects of early thrombolysis with improvement in infarct size reduction, cardiac performance and early mortality.--The importance of the time factor and the implications regarding information of potential patients and practitioners and organization of rapid hospitalization are outlined. Follow-up (after a mean of 14 months) of our 72 thrombolysis patients revealed a high percentage of patients still dependent on medical care, reduced physical capacity in almost half of the patients and (a favourable result) a large number of patients who stopped smoking after the infarction. --In view of the slight additional stress caused by this therapy for patients, physicians and nursing staff, the use of thrombolytic agents in acute myocardial infarction should (with strict inclusion/exclusion criteria) be rapidly generalized in the hospitals of Switzerland.