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Eligibility doesn’t always mean therapy
ORLANDO-The sickest MI patients eligible for reperfusion therapy appear least likely to get it.
Among 84,663 acute-MI patients who met all eligibility criteria, 20,319 at 1,470 hospitals weren’t reperfused. All had diagnostic ECG changes, presentation within six hours, and no contraindications to thrombolysis, shows the National Registry of Myocardial Infarction.
And prominent in that group were those with increased risk for in-hospital mortality-patients with prior congestive heart failure, stroke, or MI; those over age 75 or in Killup class 2 to 4; those with diabetes; and women-says Dr. Hal Barron of UCSF and Genentech.
The rates of patients getting thrombolysis, primary PTCA, or immediate CABG ranged from more than a third to 88% of those without increased risk, he told the American Heart Association meeting here.
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