We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Efficacy of thrombolysis in patients with acute myocardial infarction requiring cardiopulmonary resuscitation.
- Authors
Ruiz-Bailén, M.; de Hoyos, Aguayo E.; Serrano-Córcoles, M.; Díaz-Castellanos, M.; Ramos-Cuadra, J.; Reina-Toral, A.; Ruiz-Bailén, M; Aguayo de Hoyos, E; Serrano-Córcoles, M C; Diáz-Castellanos, M A; Ramos-Cuadra, J A
- Abstract
<bold>Objective: </bold>To evaluate the efficacy and safety of systemic thrombolysis administered to resuscitated patients after cardiac arrest (CA) due to an acute myocardial infarction (AMI), through a study of their mortality and haemorrhagic complications.<bold>Design: </bold>We studied a retrospective cohort of patients with ischaemic heart disease gathered from the database of the Spanish multi-centre project "Analysis of Delay in AMI" (ARIAM).<bold>Setting: </bold>Intensive care (ICU) and coronary care (CCU) units of 77 Spanish hospitals.<bold>Patients and Participants: </bold>The study period was from 1 January 1995 to 1 January 2000, when 22,922 patients were included in the ARIAM database register; 13,704 were diagnosed with AMI and we studied 303 of these AMI patients admitted after resuscitation for CA.<bold>Measurements and Results: </bold>Of the 303 patients studied, 228 were male (75.25%); the mean age was 64.57 +/- 12.48 years. Systemic thrombolysis was administered to 67 patients (group I) and the remaining 236 patients were managed without this treatment (group II). The ICU/CCU mortality rate of the series was 39.93 % (121 patients); that of group I was 17.91% (12 patients) and that of group II 46.18% (109 patients) (P < 0.00001). Group I required less mechanical ventilation (group I, 42.85% vs group II, 80.76 %; P < 0.00001) and fewer cardiopulmonary resuscitation attempts (33.34% vs 60.98%, P < 0.0001). Group I also showed a lower incidence of cardiogenic shock (14.28% vs 39.01%, P < 0.0001) and anoxic encephalopathy (8.62% vs 39.89% P = 0.006). There were no fatal haemorrhagic complications in either group. Logistic regression analysis showed the administration of thrombolysis to be an independent variable that protected against mortality.<bold>Conclusions: </bold>The administration of thrombolysis to patients with AMI who require resuscitation may be efficacious in reducing mortality and is safe, with no increase in haemorrhagic complications.
- Subjects
SPAIN; THROMBOLYTIC therapy; CRITICAL care medicine complications; CARDIAC arrest; MYOCARDIAL infarction; MULTIVARIATE analysis; MYOCARDIAL infarction-related mortality; ARTIFICIAL respiration; CARDIOPULMONARY resuscitation; DATABASES; INTENSIVE care units; MEDICAL cooperation; RESEARCH; RETROSPECTIVE studies; DISEASE complications
- Publication
Intensive Care Medicine, 2001, Vol 27, Issue 6, p1050
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s001340100948