Indications for Fibrinolytic Therapy
Class I
1. In the absence of contraindications, fibrinolytic therapy
should be administered to STEMI patients with
symptom onset within the prior 12 hours and ST elevation greater than 0.1 mV in at least 2 contiguous precordial leads or at least 2 adjacent limb leads. (Level of Evidence: A)
2. In the absence of contraindications, fibrinolytic therapy
should be administered to STEMI patients with
symptom onset within the prior 12 hours and new or
presumably new LBBB. (Level of Evidence: A)
Class IIa
1. In the absence of contraindications, it is reasonable to
administer fibrinolytic therapy to STEMI patients with
symptom onset within the prior 12 hours and 12-lead ECG
findings consistent with a true posterior MI. (Level of
Evidence: C)
2. In the absence of contraindications, it is reasonable
to administer fibrinolytic therapy to patients with
symptoms of STEMI beginning within the prior 12
to 24 hours who have continuing ischemic symptoms
and ST elevation greater than 0.1 mV in at least 2
contiguous precordial leads or at least 2 adjacent limb
leads. (Level of Evidence: B)
Class III
1. Fibrinolytic therapy should not be administered to
asymptomatic patients whose initial symptoms of
STEMI began more than 24 hours earlier. (Level of
Evidence: C)
2. Fibrinolytic therapy should not be administered to patients
whose 12-lead ECG shows only ST-segment depression
except if a true posterior MI is suspected. (Level of Evidence: A)
0 comments: