What is the door-to-needle time for fibrinolysis in acute myocardial infarction?

• A. 15 minutes
• B. 60 minutes
• C. 30 minutes
• D. 90 minutes

Answer: (C)

In acute myocardial infarction, the speed of reperfusion is critical because myocardium dies with every passing moment. When fibrinolysis is chosen, the interval from hospital arrival to giving the fibrinolytic drug should be 30 minutes or less. This 30-minute door-to-needle window minimizes infarct size and improves survival. If timely primary PCI can be done within about 90 minutes of first medical contact, that approach is preferred, but if PCI isn’t available quickly, fibrinolysis should still be given as soon as possible, aiming for that same 30-minute arrival-to-drug timing.