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The WHO reports that cardiovascular disease is the leading cause of death worldwide, with >80% of these deaths occurring in lower-income and middle-income countries (LMICs).1 ST-elevation myocardial infarction (STEMI) can be treated either with percutaneous coronary interventions (PCIs) or thrombolytic agents, which are most effective if given in the first few minutes to hours after onset of symptoms. While traditionally thrombolysis is given in-hospital, prehospital thrombolysis is proposed as an effective intervention to save time and reduce mortality and morbidity in individuals with STEMI. Despite some evidence that prehospital thrombolysis may be delivered safely, there is a paucity of data from controlled trials to indicate whether the timing of delivery can be effective in reducing key clinical outcomes specifically in STEMI in LMICs.
In this Cochrane Corner, we highlight a Cochrane review2 that assessed the effect of prehospital compared with in-hospital thrombolysis for STEMI. A comprehensive search conducted in June 2014 …
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Contributors All authors contributed equally to the design, writing and editing of this article.
Provenance and peer review Commissioned; externally peer reviewed.