Selection factors for the use of thrombolytic treatment in acute myocardial infarction: a population based study of current practice in the United Kingdom. The European Secondary Prevention Study Group.

Abstract

The patient population admitted to hospital with acute myocardial infarction differs in several respects from the samples that have been included in the trials of thrombolysis. The main factors limiting wider use of thrombolysis are diagnostic uncertainty at admission and delayed presentation. Perceived clinical contraindications to treatment are of lesser importance. There is evident reluctance to use thrombolytic treatment in older patients, who were substantially under-represented in the clinical trials.