Cuidados com a terapia trombolítica em pessoas com infarto agudo do miocárdio: revisão de escopo

Abstract

Diseases of the circulatory system are the leading cause of death in Brazil and worldwide. These conditions also include acute coronary syndromes, such as acute myocardial infarction. In these cases, restoring perfusion by clearing or dissolving the thrombus in the coronary circulation is essential. This reperfusion approach is performed through percutaneous coronary intervention or thrombolytic therapy in patients without contraindications. The care provided by thrombolytic therapy will be addressed in this study. OBJECTIVE: To map the scientific evidence on the care provided by thrombolytic therapy in people with acute myocardial infarction. METHOD: This is a scoping review, following the methodological assumptions of the Joanna Briggs Institute (JBI) and the PRISMAScR methodology. The review followed these steps: 1) identification of the research question; 2) identification of relevant studies; 3) selection of studies; 4) data extraction; 5) separation, summarization, and reporting of results; and 6) dissemination of results. The research question was delimited using the mnemonic PCC, so the established question was: “What scientific evidence is available on the care of thrombolytic therapy in adults and elderly people with AMI at different levels of healthcare?”. Original articles published in full, secondary studies, reviews, and guidelines, in all languages, from 2015 to 2025 were included. The searches were implemented in the following databases: PubMed, Web of Science, CINAHL, EMBASE, LILACS, SCIELO, SCOPUS, Medline, BDENF, Cochrane Library, and the Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel (CAPES), using Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH). RESULTS: The final sample consisted of 14 studies, with an average annual publication rate of 1.4 articles between 2016 and 2025. Of these, 57.1% were from Asia, 92.2% were in English, 57.1% employed a qualitative approach, and 42.8% were classified as level VII evidence. The studies addressed topics listed in thematic axes, such as: reperfusion strategies, pre-hospital thrombolysis, thrombolytic therapy, relative and absolute contraindications, adverse events and complications, and classification scores. CONCLUSION: This study mapped scientific evidence regarding the care that should be followed when using thrombolytic therapy, identifying aspects that influence the therapeutic choice for treatment. Based on the findings, the importance of this study for elucidating safe practices and providing safe and organized nursing care in the face of cardiovascular events is highlighted.