Eligibility for streptokinase thrombolysis during evolving acute myocardial infarction. An historical cohort study.

To determine the percentage of acute myocardial infarction patients suitable for streptokinase thrombolysis, the charts of 990 patients from four separate hospitals with a discharge diagnosis of acute myocardial infarction were studied. In all, 750 were confirmed to actually have suffered acute myocardial infarction by enzyme and electrocardiogram criteria. Of these, 233 (31 percent of all patients with acute myocardial infarction) were judged to be suitable streptokinase candidates by virtue of being 75 years of age or younger, showing evidence of acute transmural infarction, having no contraindications to anticoagulation, and presenting to the Emergency Room within six hours or less after onset of chest pain. It is concluded that approximately one-third of all acute myocardial infarction patients in this population were eligible for streptokinase thrombolysis and that there is therefore a significant continuing role for traditional acute myocardial infarction management.