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Translation of clinical trials into practice: a European population-based study of the use of thrombolysis for acute myocardial infarction / Woods KL, Ketley D, Agusti A, Hagn C, Kala R, Karatzas NB, Leizorowicz A, Lowy A, Reikvam A, Schilling J, Seabra-Gomes R, Vasiliauskas D, Wilhelmsen L
Type of publication
Straipsnis Web of Science duomenų bazėje / Article in Web of Science database (S1a)
Author(s)
Woods, Kent L. | Leicester Royal Infirmary, Leicester, UK |
Ketley, Diane | Leicester Royal Infirmary, Leicester, UK |
Agusti, Antonia | CSU Vall Hebron, Barcelona, Spain |
Hagn, C. | Innsbruck University, Innsbruck, Austria |
Kala, Risto | Maria Hospital, Helsinki, Finland |
Karatzas, N.B. | Hygeia Hospital, Athens, Greece |
Leizorowicz, Aalain | Unite de Pharmacologie Clinique, Lyon, France |
Lowy, Andrew | |
Reikvam, Aamund | Ulleval University Hospital, Oslo, Norway |
Schiling, J. | Institute for Social and Preventive Medicine, University of Zurich, Zurich, Switzerland |
Gomes, Raquel Zita | University of Oporto, Oporto, Portugal |
Wilhelmsen, Lars | Östra University Hospital, Gothenburg, Sweden |
Title
Translation of clinical trials into practice: a European population-based study of the use of thrombolysis for acute myocardial infarction / Woods KL, Ketley D, Agusti A, Hagn C, Kala R, Karatzas NB, Leizorowicz A, Lowy A, Reikvam A, Schilling J, Seabra-Gomes R, Vasiliauskas D, Wilhelmsen L
Publisher (trusted)
Lancet Publishing Group |
Is Referenced by
Date Issued
Date Issued |
---|
1996-05-04 |
Extent
p. 1203-1207.
Is part of
Lancet. New York : Lancet Publishing Group, 1996, vol. 347, no. 9010.
Version
Originalus / Original
Field of Science
Abstract
Background There is conclusive evidence from clinical trials that thrombolytic therapy reduces mortality in acute myocardial infarction (AMI). But still only a minority of patients admitted with AMI receive a thrombolytic drug, We have looked at a sample of AMI patients from several centres to study which factors limit the widespread use of thrombolytic therapy. Methods From eleven European countries, we drew a sample of 4035 patients who were discharged or died in hospital with a diagnosis of AMI between January, 1993, and June, 1994. From the medical records, we obtained the observed rate of thrombolytic use, and we defined the shortfall as the proportion of patients with no contraindication but who did not receive a thrombolytic. Findings Thrombolytic treatment had been used in 13-52% (median 36%) of the patients. Among untreated patients, we identified three groups of similar size: those whose symptom onset was more than 12 h (or unknown) before presentation; those causing diagnostic difficulty at presentation and/or lacking ECG criteria for treatment; and those with no apparent reason for withholding thrombolytic treatment (ie, the shortfall, which was 20%), Logistic regression analysis in all patients without contraindications showed that older patients and women were less likely to receive thrombolytic treatment, The adjusted odds ratio for female sex was 0 . 69 (95% CI 0 . 53-0 . 89), and that for age 65-74, for instance (versus 0-44), was 0 . 55 (0 . 34-0 . 89). These factors of age and sex were independent, and we noted that older patients and women were under-represented in the clinical trials of thrombolytic therapy for AMI. Interpretation We confirmed that only about one-third of patients admitted to European hospitals with AMI receive a thrombolytic drug, Allowing for delays to presentation and difficulty of early diagnosis, the maximum rate of thrombolysis is about 55%. [...].
Type of document
type::text::journal::journal article
ISSN (of the container)
0140-6736
WOS
A1996UJ59700007
Other Identifier(s)
(LSMU ALMA)990000419470107106
Coverage Spatial
Jungtinės Amerikos Valstijos / United States of America (US)
Language
Anglų / English (en)
Bibliographic Details
47