Treatment and outcome of patients with acute myocardial infarction and prior cerebrovascular events in the thrombolytic era: the Israeli Thrombolytic National Survey.
Open Access
- 23 March 1998
- journal article
- clinical trial
- Published by American Medical Association (AMA) in Archives of internal medicine (1960)
- Vol. 158 (6) , 601-606
- https://doi.org/10.1001/archinte.158.6.601
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.18,19Keywords
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