BMJ  2008;336:401-402 (23 February), doi:10.1136/bmj.39475.482419.80

Editorials

Treatment delays in ST elevation myocardial infarction

Can be reduced by prehospital diagnosis and direct transfer to high volume catheterisation laboratories

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

Quickly re-establishing coronary blood flow is vital in patients with ST elevation myocardial infarction. Two recently published systematic reviews summarise the evidence on this form of treatment.^{1 2} The first review concluded that primary percutaneous coronary intervention (PCI) is the best reperfusion strategy if performed quickly, and it identified "door to balloon time" (the time from arrival at hospital to balloon inflation) as a key predictor of outcome in people given this treatment.¹ The second review stated that "inevitable transport delays commonly limit the benefit of PCI."² The reviews reflect an ongoing controversy in cardiology—when is PCI the best reperfusion strategy, and when should fibrinolysis be considered as an alternative?

What is an acceptable time window in which to deliver PCI? The review by Boden and colleagues and current guidelines recommend using fibrinolysis if the extra time needed to perform percutaneous coronary intervention (the PCI related delay) is more than 60 . . . [Full text of this article]

¹ Department of Cardiology B, Aarhus University Hospital, DK-8200 Aarhus N, Denmark

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

Relevant Article

Prognosis and politics

Fiona Godlee
BMJ 2008 336: 0. [Extract] [Full Text]

This article has been cited by other articles:

• Terkelsen, C. J., Sorensen, J. T., Nielsen, T. T. (2008). Is There Any Time Left for Primary Percutaneous Coronary Intervention According to the 2007 Updated American College of Cardiology/American Heart Association ST-Segment Elevation Myocardial Infarction Guidelines and the D2B Alliance?. J Am Coll Cardiol 52: 1211-1215 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

The usefuleness of pre-hospital thrombolysis has been ignored

Georgios Lyratzopoulos
bmj.com, 24 Feb 2008 [Full text]

Prehospital fibrinolysis or prehospital rerouting for primary PCI ?

Christian J Terkelsen
bmj.com, 24 Feb 2008 [Full text]