Pre-hospital thrombolysis in ST-segment elevation myocardial infarction: A regional Australian experience

John K. French, Derek P. Chew, Richard W. Harper, Philip E.G. Aylward

    Research output: Contribution to journalLetterpeer-review


    We commend Kahn and colleagues for publishing their data on the pre‐hospital use of fibrinolysis and showing that the outcomes were similar to those treated by primary percutaneous coronary intervention (PCI). However, we noted that the median first medical contact to device time for those receiving primary PCI was 130 minutes, and indeed > 75% of patients had longer than the 90 minutes recommended in the recent National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand guidelines.2 Although there is still some uncertainty about acceptable time delays to PCI, these data suggest that even more individuals should be receiving pre‐hospital thrombolysis. As an alternative, perhaps patients should be randomised in clinical trials that address the relative usefulness of these two reperfusion strategies in circumstances of likely moderately prolonged times to primary PCI. Moreover, among those patients undergoing pharmaco‐invasive PCI, the dose of the fibrinolytic drugs used requires definition.3
    Original languageEnglish
    Pages (from-to)369
    Number of pages1
    JournalMedical Journal of Australia
    Issue number8
    Publication statusPublished - 1 May 2017


    • Letter to editor
    • myocardial infarction
    • regional Australia


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