Rapid Triage, Transfer, and Treatment with Percutaneous Coronary Intervention for Patients with ST-Segment Elevation Myocardial Infarction

James C Blankenship, MD and Kimberly A Skelding, MD
Percutaneous coronary intervention (PCI) is the most effective treatment for ST-segment elevation myocardial infarction, when it is readily available. However, when patients present to non-PCI hospitals, there is an inevitable delay before this procedure can be performed. In Europe, transfer for PCI may be more effective than on-site fibrinolytic therapy; however, this advantage is not as clear in the US where inter-hospital distances are longer and emergency services are not as well organized. This article reviews data suggesting that prehospital electrocardiography, ambulance bypass of non-PCI centers, efficient interhospital transfer, and rapid triage/treatment at non-PCI hospitals and PCI centers are essential in decreasing door-to-balloon times into the range where PCI retains its advantage over fibrinolytic therapy. Acute Coronary Syndromes 2008;9(2):59–65.
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