Thanks, that's the one.
-----Original Message-----
>From: "Jonathan Benger" <[log in to unmask]>
>Sent: 15/10/02 14:26:34
>To: "[log in to unmask]" <[log in to unmask]>
>Subject: Re: Thrombolysis and previous surgery
>
>>From the FTT review (1):
>
>Numbers needed to treat with thrombolysis (to save one life):
>Anterior MI: 28
>Inferior MI: 120
>
>Numbers needed to harm with thrombolysis (to cause one death):
>ST depression: 72 (the relation of this to posterior MI is unclear)
>Normal ECG: 144
>
>The 95% confidence intervals of the NNT in inferior MI overlap with those
>for the NNH in normal ECGs. This is not the case for anterior MI, and the
>difference is quite striking.
>
>Therefore, the location of the MI should be taken into account (along with
>age, co-morbidity, sex, warfarin use, recent surgery, bleeding risk, etc,
>etc) when considering the risk/benefit ratio for each patient eligible for
>thrombolysis.
>
>Regards,
>
>Jonathan Benger.
>SpR, Bath.
>
>(1) Fibrinolytic therapy trialists' (FTT) collaborative group. Indications
>for fibrinolytic therapy in suspected acute myocardial infarction:
>collaborative overview of early mortality and major morbidity results of all
>randomised trials of more than 1000 patients. Lancet 1994;343:311-322.
>
>-----Original Message-----
>From: Accident and Emergency Academic List
>[mailto:[log in to unmask]]On Behalf Of Goat
>Sent: 13 October 2002 20:59
>To: [log in to unmask]
>Subject: Re: Thrombolysis and previous surgery
>
>
>I couldn't remember where I had heard this. Thanks for reminding me,
>Rowley.
>
>When I saw the original post, I went on the hunt for any guidelines on
>the web differentiating between inferior and anterior MI for lysis - got
>zip. Our Trust guidelines don't differentiate between MI sites for
>lysis.
>
>Is this one of those cases where the "evidence" has been over-sold?
>
>Which of the many lysis trials can we get such info from? I coudl find
>nothing on a quick title search on medline this pm.
>
>Yes, you're right Rowley, I am just too lazy to look further myself, or
>is it just too tired! Throw me a bone!
>
>Goat
>
>
>
>In article <[log in to unmask]>,
>Rowley Cottingham <[log in to unmask]> writes
>>Um, there is no evidence that thrombolysis affects the outcome in inferior
>MIs,
>>you know.
>>
>>Best wishes,
>>
>>
>>Rowley Cottingham
>>
>>[log in to unmask]
>>http://www.emergencyunit.com
>
>Dr G Ray
>A&E
>Sussex
>Reply to [log in to unmask]
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