Who receives the most benefit from reperfusion therapy?

Patients with new bundle branch block receive the highest benefit from reperfusion therapy, followed by patients with acute anterior STEMI, and then acute inferior STEMI.

When fibrinolytic therapy is administered to patients with ST segment depression only, we kill an additional 14 patients per 1000 treated.

When fibrinolytic therapy is administered to patients with a “normal” admission 12 lead ECG, we kill an additional 7 patients per 1000 treated.

The Fibrinolytic Therapy Trialists (FTT) Collaborative Group obtained patient data from over 60,000 patients in 22 trials. Of those, 4% had BBB, 68% had ST segment elevation, 7% had ST segment depression, 17% had other abnormalities (e.g., inverted T waves), and 5% had near-normal ECGs.

See also

Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet 1994; 343: 311-22

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