Prehospital thrombolysis in AMI: a feasible alternative to Brazil?

Mailing address: Carisi A. Polanczyk • Hospital de Clinicas de Porto Alegre Rua Ramiro Barcelos 2350, sala 2060 90035-903 Porto Alegre, RS Brazil E-mail: cpolanczyk@hcpa.ufrgs.br Coronary artery disease (CAD) remains the main cause of mortality, with Acute Myocardial Infarction (AMI) contributing with approximately one-third of the death cases. In this context, the therapeutic resources used to reduce the unfavorable outcomes related to this disease, mainly in its acute form, have significantly increased. The advent of the thrombolytic therapy, for instance, represented a considerable advance in the treatment of AMI. Large randomized clinical trials published in the 80s such as GISSI and ISIS 2 have consistently demonstrated the decrease in mortality associated to these drugs when used timely after the onset of AMI symptoms, with its effectiveness being time-dependent and exponential, i.e., earlier the start of drug infusion, greater the clinical benefit.

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