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Less than half of patients with acute myocardial infarction and diagnostic ECG changes receive thrombolysis. Even after eliminating those with contraindications, up to 20 percent of MI patients who meet criteria for thrombolysis or emergent angioplasty do not receive these treatments. U.S. and Canadian investigators examined whether early availability of serum markers for MI would increase the appropriate use of reperfusion therapy.
In a multicenter, prospective trial, 6352 patients were randomized to have myoglobin and CK-MB assays performed at 0 and 1 hour (stat) after ED presentation or at 3 or more hours (control). A total of 814 patients were diagnosed with acute MI. There was no difference in the use of thrombolytic therapy between the…