Potential influence of previous medical pathology on use of thrombolysis in the elderly with suspected acute myocardial infarction.

A perceived reluctance by many doctors to consider the use of thrombolytic therapy in elderly patients with acute myocardial infarction prompted us to investigate the potential influence of pre-existing medical pathology on use of fibrinolysis. Of 251 patients consecutively admitted to hospital with suspected acute myocardial infarction, absolute contra-indications to thrombolysis were found in 9 (4%) patients and relative contra-indications in a further 82 (31%) patients. This study suggests that the presence of contra-indications plays a small role in influencing the potential use of thrombolysis in the elderly. Age itself should not be assumed to be inevitably associated with an unacceptable rate of contra-indications for thrombolytic therapy.