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Fibrinolytic treatment in suspected acute myocardial infarction--use and risks in clinical practice

B Beermann1, C von Bahr, A Sundström

  • 1Department of Drug Epidemiology, Information and Inspection, Medical Products Agency, Uppsala, Sweden.

European Journal of Clinical Pharmacology
|January 1, 1997
PubMed

Insights

Fibrinolytic treatment adherence for suspected myocardial infarction varied significantly across Swedish hospitals in 1994. This suggests suboptimal use of these critical reperfusion therapies in clinical practice.

Area of Science:

  • Cardiology
  • Clinical Practice Guidelines
  • Health Services Research

Background:

  • Adherence to fibrinolytic treatment guidelines for acute myocardial infarction (AMI) is crucial for patient outcomes.
  • Variability in clinical practice may indicate suboptimal care delivery.

Purpose of the Study:

  • To assess adherence to guidelines for fibrinolytic therapy in suspected myocardial infarction.
  • To investigate the occurrence of severe events and treatment patterns in Swedish clinical practice.

Main Methods:

  • Prospective data collection from 69 Swedish coronary care units over 4 months in 1994.
  • Inclusion of 9,726 patients admitted for suspected acute myocardial infarction.
  • Analysis of treatment adherence, delays, and drug choices.

Main Results:

  • Only 56% of eligible patients received timely fibrinolytic treatment (delay < 12 hours, no contraindications).
  • Significant interhospital variation in treatment rates (18.1%–94.1%).
  • Delayed treatment (> 24 hours) occurred in 12.5% of women and 15.7% of men; 36.1% of confirmed AMI patients received fibrinolysis.

Conclusions:

  • Fibrinolytic therapy appears to be used inconsistently across hospitals.
  • Implementation of local quality improvement systems is recommended to enhance patient care.
Abstract

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