Treatment and outcome of patients with acute myocardial infarction and prior cerebrovascular events in the thrombolytic era: the Israeli Thrombolytic National Survey.

Abstract
SEVERAL large-scale clinical trials have shown that thrombolytic therapy limits infarct size, preserves left ventricular function, and decreases mortality after acute myocardial infarction (MI).1-5 Nevertheless, thrombolytic therapy is underused.6-10 The most feared complication of thrombolysis is the development of an intracranial hemorrhage, which is associated with high mortality rates and severe disability in survivors.11-17 Therefore, most patients with a history of stroke are excluded from thrombolytic trials,5 and thrombolysis is substantially less likely to be used in clinical practice among patients with a prior stroke, even if it is remote to the index MI.8,9 In some of the recent guidelines on the management of acute MI, prior stroke is considered a definite contraindication to thrombolytic therapy.18,19

This publication has 1 reference indexed in Scilit: