Norwegian Study on District Treatment of ST-Elevation Myocardial Infarction

Benefits and Costs in Two Different Strategies for Treating Acute Myocardial Infarction With ST-Elevation.

In the district areas of Norway patients with acute myocardial infarction with ST-elevation, are treated with thrombolysis. An increasing part of them receives thrombolysis before arrival to the local hospital.Usually these patients have been sent to an invasive center if thrombolysis fails or the patient gets ischemic symptoms during the stay.

This study will compare this strategy against immediate transportation to an invasive center after the patient has received thrombolysis.

Inclusion Criteria:

• Duration of painless than 6 hours.
• ST-segment elevation of at least 0.1 mV in two or more extremity leads or at least 0.2 mV in two or more precordial leads.
• The patient is getting thrombolysis.
• Time to reach an invasive center is more than 1 hour.
• Age 18-75 years.

Exclusion Criteria:

• Known serious renal failure (creatinin > 250 mmol/l)
• Pregnancy
• Cardiogenic chock
• Life threatening arrythmias
• Other serious diseases with life expectancy less than 1 year.
• Inability to perform an informed consent