Causas de la no-trombólisis en el infarto agudo del miocardio y beneficios de su uso

a descriptive study with risk approach was undertaken by reviewing 242 medical histories of the living discharged patients or dead patients with diagnosis of acute myocardial infarction at "dr. salvador allende" clinical and surgical teaching hospital , aimed at determining the main causes for deferring the thrombolytic treatment in this entity. thrombolysis was performed in 29.8 % of the patients with acute myocardial infarction that received attention at that institution; however, in 11.6 % of the cases thrombolysis was not applied without any justification. the fundamental reasons for not using thrombolysis were the arrival to the hospital 12 hours after the onset of the pain (17.4 %) and the nonelevation of the st segment (11.2 %). age over 75 was not a nonelection risk for the thrombolytic treatment (or = 1,45 [0,75-2,81 ic = 95 %]; p = 0,267). mortality from acute myocardial infarction is still high (26 %).. age over 75 (or = 3,41 (1,83-6,35 ic = 95%]; p = 0,000), the arrival to the hospital after 6 hours (or = 2,36 [1,17-4,75 ic = 95 %]; p = 0,014), and the nonapplication of the thrombolytic treatment (or = 3,82 [1,71-8,53 ic = 95 %]; p = 0,001) were risk elements related in a statistically significant way to the lethality of infarction. the risk for dying was maintained even in those patients who did not undergo thrombolysis of the subgroup over 75 years old. (or = 8,04 [1,63-39,69 ic = 95 %]; p = 0,004).