[Use of thrombolysis for myocardial infarction in Israel].

Thrombolysis is generally accepted as the initial treatment for acute myocardial infarction. The extent to which this therapy is being implemented in Israel and the reasons for exclusion of cases from thrombolytic therapy were prospectively investigated. 413 consecutive patients with acute myocardial infarction hospitalized during January 1990 in 18 of Israel's 25 coronary care units were studied. Thrombolytic therapy was administered to 145 patients (35%: 38% of the men and 29% of the women; NS). It was used more often in those up to the age of 75 (38%) than in those over (18%, p less than 0.005) and in those with a first or anterior infarction (40% and 48%, respectively) than those with recurrent or inferior infarction (23% and 31%, respectively; p less than 0.005 for both). The 2 most frequent reasons for not using thrombolysis were late arrival in the coronary care unit (33%) and absence of ST elevation on the admission electrocardiogram (28%). Hospital mortality was 6% in the thrombolytic group versus 20% in those ineligible for thrombolysis. The significance of this difference is not clear as there was no randomization to treatment.