Article Abstract:
Prehospital thrombolytic therapy may be effective and safe for patients who are having a suspected heart attack. Thrombolytic therapy is treatment with different drugs that break up blood clots. Among 5,469 heart attack patients who had thrombolytic therapy with anistreplase, 2,750 were treated before being hospitalized and 2,719 were treated after hospitalization. Thrombolytic therapy was received an average of 55 minutes earlier by patients in the prehospital group. Eight percent of the patients who received prehospital thrombolytic therapy died from cardiac causes, compared with 10% of those who received thrombolytic therapy in the hospital. The incidence of most side effects was similar among the two groups of patients.
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Article Abstract:
All patients who have a suspected heart attack should be given aspirin and thrombolytic drugs as soon as possible. Thrombolytic drugs break up the blood clots that cause most heart attacks. Aspirin has been shown to significantly reduce mortality rates in patients with suspected heart attack or severe angina. It also reduces the risk of a second heart attack or stroke. The anticoagulant heparin can be added to aspirin, but it can also cause bleeding. Different thrombolytic drugs seem to have similar effects except that tissue plasminogen activator (t-PA) increases the risk of stroke.
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Article Abstract:
This article discusses a study showing that analysis of disease rates among subjects upon follow-up generally underestimates real associations of disease risk with their baseline measures. The study suggests that risk factors be remeasured at varying intervals after the initial baseline survey to avoid 'regression dilution.'
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