Pre-hospital fibrinolysis in the patient with acute coronary syndrome with ST-segment elevation: history and recommendations

Pacheco Rodríguez A, Lara Sánchez JJ

Fibrinolytic therapy has been called one of the most important advances for achieving

coronary reperfusion in the management of acute coronary syndrome with ST-segment

elevation. The efficacy of this measure depends on how quickly it is implemented,

however. Percutaneous coronary intervention has since been shown to be more

efficatious than fibrinolysis. Timely provision of this treatment within the therapeutic

window is not available to a large proportion of patients, however, given that it is

provided only in specialized centers, a situation responsible for long delays. Prehospital

fibrinolytic therapy therefore continues to be an efficatious measure for many. We review

the history of fibrinolysis in acute coronary syndrome with ST-segment elevation and

offer recommendations for approaches to coronary reperfusion, discussing key points to

consider in deciding between fibrinolytic therapy or percutaneous coronary intervention.

Lara Sánchez JJ, Pacheco Rodríguez A