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document
The European Myocardial Infarction Project : an assessment of pre-hospital thrombolysis . The use of thrombolytic agents in patients with suspected myocardial infarction has been shown to reduce early and long-term mortality by about 20 % , and it has been suggested that since time is an important factor , pre-hospital treatment would give better results . However , health deciders need reliable data on which to base future policies concerning this . The European Myocardial Infarction Project was a European Economic Community-supported double-blind study designed to evaluate the efficacy and safety of pre-hospital early thrombolytic treatment in patients with suspected myocardial infarction compared with the same treatment given later in a hospital setting . A total of 5469 patients in 16 countries were randomised by 198 mobile emergency units to receive either pre-hospital treatment with anistreplase , the thrombolytic agent used , followed by placebo after hospital admission ( pre-hospital group ; 2750 patients ) , or placebo followed by anistreplase ( hospital group ; 2719 patients ) . The median time delay between the injections was 55 min . A non-significant decrease in 30-day mortality was observed in favour of the pre-hospital group ( 13 % : P = 0.08 ) , whereas the decrease in cardiac death observed , also in favour of the pre-hospital group , was on the borderline of significance ( 16 % ; P = 0.049 ) . Although some complications occurred more frequently in the pre-hospital group in the pre-hospital period , the overall incidence for serious complications was similar for both groups . These results show that the pre-hospital thrombolytic strategy in patients with suspected myocardial infarction is both effective and safe when performed by well-equipped well-staffed mobile emergency units .
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Intervention_Pharmacological
thrombolytic agents
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Intervention_Pharmacological
pre-hospital early thrombolytic treatment
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Intervention_Pharmacological
anistreplase
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Intervention_Control
followed by placebo
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Intervention_Control
placebo followed by anistreplase
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Intervention_Pharmacological
pre-hospital thrombolytic strategy
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Outcome_Other
median time delay
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Outcome_Mortality
30-day mortality
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Outcome_Mortality
decrease in
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Outcome_Physical
cardiac death
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Outcome_Adverse-effects
some complications
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Outcome_Adverse-effects
overall incidence for serious complications
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Outcome_Other
thrombolytic strategy
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Outcome_Physical
myocardial infarction
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Outcome_Other
effective and safe
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Participant_Condition
thrombolysis
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Participant_Condition
myocardial infarction
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Participant_Condition
myocardial infarction
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Participant_Sample-size
5469 patients