Effect of Pre-hospital Thrombolysis on Mortality in Patients with Myocardial Infarction: A Systematic Review and Meta-analysis

Background and Early treatment of thrombolysis can reduce mortality in patients with myocardial infarction, so, this systematic review and meta-analysis aimed to compare the effect of pre-hospital thrombolysis and in-hospital thrombolysis on short-term mortality in patients with myocardial infarction.
Systematic search was conducted in electronic databases including Pubmed, Web of Science, Cochrane, and Embase without time and language constraints using related keywords. All articles were exported to EndNote. In initial search, 223 articles were found but finally 10 articles were selected for quality assessment, which was performed using the JADAD standard checklist for interventional studies and the Newcastle Ottawa Scale checklist for cohort studies. Comprehensive Meta-Analysis software was used for data analysis.
The total samples size was 4291 in the pre-hospital group and 4,730 in the in-hospital group. Three clinical trials and all three cohort studies were found to have a good quality. Meta-analysis showed that thrombolytic therapy at the onset of symptoms and prior to patient's transfer to hospital could reduce mortality by 36% (OR= 0.64 CI 95%: 0.45-0.91).
Pre-hospital thrombolysis by emergency technicians can reduce mortality in patients with myocardial infarction.