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The quest to identify safe and effective strategies to minimize time to reperfusion for patients with ST-segment–elevation myocardial infarction (STEMI) has been ongoing for decades. Researchers evaluated the feasibility of paramedic-administered tenecteplase therapy in an urban Canadian emergency medical services system.
They conducted a prospective, observational assessment of all patients with STEMI who were enrolled in the industry-sponsored ASSENT 3+ trial, comparing time to treatment, clinical events, and mortality in 119 patients who had received prehospital fibrinolysis and 484 who had received inhospital therapy.
Mean time from symptom onset to treatment was 55 minutes shorter in the prehospital group (103 vs. 158 minutes), a signifi…