BMJ  2004;328:1567 (26 June), doi:10.1136/bmj.328.7455.1567-b

Letter

Reduce door to needle, not door to balloon, times first

The first 150 words of the full text of this article appear below.

EDITOR—Primary angioplasty may well prove to be the gold standard for treatment of ST elevation myocardial infarctions in the future, as Smith advocates,1 but for the moment I foresee many factors against angioplasty. This is especially highlighted in the Isle of Wight, the main factor being the postcode lottery.

Studies with an average door to balloon time of 1 hour and 56 minutes were conducted in the United States, where distances to centres that can perform angioplasties can be quite different from those in the United Kingdom. Additionally, the Isle of Wight is unique because a vehicle ferry is required to transport patients to a tertiary referral centre. Door to balloon times are hence significantly greater than 1 hour as the crossing itself is 55 minutes alone.

I cannot see angioplasties ever becoming the gold standard until primary angioplasty centres are developed in district general hospitals. It requires . . . [Full text of this article]

Sharif Hossain, senior house officer in medicine

Cowes, Isle of Wight PO31 7FB sharif.hossain@doctors.org.uk


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Primary angioplasty should be first line treatment for acute myocardial infarction: FOR
David Smith
BMJ 2004 328: 1254-1256. [Extract] [Full Text] [PDF]

Access jobs at BMJ Careers
Whats new online at Student BMJ