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Thrombolytic therapy in suspected ac...

Rosamond, Wayne Daniel.

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Thrombolytic therapy in suspected acute myocardial infarction: Assessment of practice patterns and outcomes.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Thrombolytic therapy in suspected acute myocardial infarction: Assessment of practice patterns and outcomes./
Author:	Rosamond, Wayne Daniel.
Description:	300 p.
Notes:	Source: Dissertation Abstracts International, Volume: 53-07, Section: B, page: 3428.
Contained By:	Dissertation Abstracts International53-07B.
Subject:	Health Sciences, Public Health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9236975

Thrombolytic therapy in suspected acute myocardial infarction: Assessment of practice patterns and outcomes.
Rosamond, Wayne Daniel.

Thrombolytic therapy in suspected acute myocardial infarction: Assessment of practice patterns and outcomes. - 300 p.

Source: Dissertation Abstracts International, Volume: 53-07, Section: B, page: 3428.

Thesis (Ph.D.)--University of Minnesota, 1992.

The efficacy of coronary thrombolytic agents in the treatment of acute myocardial infarction (AMI) has been demonstrated in randomized clinical trials. However, transfer of experiences from clinical trials to the usual clinical setting is often varied and incomplete. The purpose of this study is to assess the practice patterns and outcomes of coronary thrombolytic therapy as they occur in a variety of community hospitals in the Minneapolis-St. Paul metropolitan area.Subjects--Topical Terms:

1017659
Health Sciences, Public Health.

Thrombolytic therapy in suspected acute myocardial infarction: Assessment of practice patterns and outcomes.
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008 130614s1992 eng d
035 $a (UnM)AAI9236975
035 $a AAI9236975
040 $a UnM $c UnM
100 1 $a Rosamond, Wayne Daniel. $3 1928027
245 1 0 $a Thrombolytic therapy in suspected acute myocardial infarction: Assessment of practice patterns and outcomes.
300 $a 300 p.
500 $a Source: Dissertation Abstracts International, Volume: 53-07, Section: B, page: 3428.
500 $a Adviser: Russell V. Luepker.
502 $a Thesis (Ph.D.)--University of Minnesota, 1992.
520 $a The efficacy of coronary thrombolytic agents in the treatment of acute myocardial infarction (AMI) has been demonstrated in randomized clinical trials. However, transfer of experiences from clinical trials to the usual clinical setting is often varied and incomplete. The purpose of this study is to assess the practice patterns and outcomes of coronary thrombolytic therapy as they occur in a variety of community hospitals in the Minneapolis-St. Paul metropolitan area.
520 $a In 1990, all patients 25 years of age or older admitted to the coronary care unit of six representative hospitals with suspicion of acute myocardial infarction were enrolled into a registry. A one year follow-up was also conducted. Of the 2,165 patients were enrolled, 585 patients were discharged as AMI (ICD9: 410). Twenty-nine percent (n = 166) of AMI patients were treated with thrombolytic therapy. The prevalence of thrombolytic therapy among AMI patients under 75 years of age was 34%. Men were more likely to be treated with thrombolytic agents as compared to women (31% men vs. 23% women). This relationship was significant after adjustment for age (p $< $. 03). The primary agent used during 1990 was tissue plasminogen activator (t-PA) (69%), however data from the registry indicated that by 1992 this proportion had declined to 45%.
520 $a Among patients receiving thrombolytic therapy, 82% has delays from chest pain to hospital admission of less than 4 hours. Coronary angiography and angioplasty were commonly used in patients receiving thrombolytic therapy, 71% and 40% respectively. Intravenous high dose heparin and regular dose aspirin was also regularly used with thrombolysis $( \ge $9 0%). Cerebral hemorrhage occurred in 1.1% of cases. Total 30 day and one year mortality for patients treated with thrombolytic therapy was 5.4% and 9.6%, respectively. One third of patients reported being hospitalized for cardiac related events during the one year follow-up.
520 $a These estimates of the use of thrombolytic therapy in community hospital practice suggest that AMI patients receive this treatment at a rate similar to that recommended. Patients receiving thrombolytic therapy experience similar or better percentages of major outcomes and complications as reported among participants of randomized clinical trials.
590 $a School code: 0130.
650 4 $a Health Sciences, Public Health. $3 1017659
650 4 $a Health Sciences, Medicine and Surgery. $3 1017756
690 $a 0573
690 $a 0564
710 2 0 $a University of Minnesota. $3 676231
773 0 $t Dissertation Abstracts International $g 53-07B.
790 1 0 $a Luepker, Russell V., $e advisor
790 $a 0130
791 $a Ph.D.
792 $a 1992
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9236975