Reperfusion Options for ST Elevation Myocardial Infarction Patients with Expected Delays to Percutaneous Coronary Intervention

David M. Larson; Peter McKavanagh; Timothy D Henry; Warren J. Cantor

doi:10.1016/j.iccl.2016.06.004

Reperfusion Options for ST Elevation Myocardial Infarction Patients with Expected Delays to Percutaneous Coronary Intervention

David M. Larson, Peter McKavanagh, Timothy D Henry, Warren J. Cantor

Medicine - Cardiology Division

Research output: Contribution to journal › Review article › peer-review

15 Scopus citations

Abstract

Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). However, only one-third of hospitals in the US have PCI availability 24/7. For non-PCI hospitals, transfer remains the optimal strategy. For expected delays of greater than 120 minutes, a pharmacoinvasive strategy is recommended. In patients with evidence of failed reperfusion or hemodynamic instability, immediate rescue PCI should be performed. All other patients should undergo routine cardiac catheterization and PCI within 24 hours after fibrinolysis. A pharmacoinvasive strategy is best implemented within an organized regional STEMI system with prospective standardized transfer protocols.

Original language	English (US)
Pages (from-to)	439-450
Number of pages	12
Journal	Interventional Cardiology Clinics
Volume	5
Issue number	4
DOIs	https://doi.org/10.1016/j.iccl.2016.06.004
State	Published - Oct 1 2016

Bibliographical note

Publisher Copyright:
© 2016 Elsevier Inc.

Keywords

Facilitated PCI
Interhospital transfer
Percutaneous coronary intervention
Pharmacoinvasive
Rural
ST segment elevation myocardial infarction

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.iccl.2016.06.004

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title = "Reperfusion Options for ST Elevation Myocardial Infarction Patients with Expected Delays to Percutaneous Coronary Intervention",

abstract = "Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). However, only one-third of hospitals in the US have PCI availability 24/7. For non-PCI hospitals, transfer remains the optimal strategy. For expected delays of greater than 120 minutes, a pharmacoinvasive strategy is recommended. In patients with evidence of failed reperfusion or hemodynamic instability, immediate rescue PCI should be performed. All other patients should undergo routine cardiac catheterization and PCI within 24 hours after fibrinolysis. A pharmacoinvasive strategy is best implemented within an organized regional STEMI system with prospective standardized transfer protocols.",

keywords = "Facilitated PCI, Interhospital transfer, Percutaneous coronary intervention, Pharmacoinvasive, Rural, ST segment elevation myocardial infarction",

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AU - Larson, David M.

AU - McKavanagh, Peter

AU - Henry, Timothy D

AU - Cantor, Warren J.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). However, only one-third of hospitals in the US have PCI availability 24/7. For non-PCI hospitals, transfer remains the optimal strategy. For expected delays of greater than 120 minutes, a pharmacoinvasive strategy is recommended. In patients with evidence of failed reperfusion or hemodynamic instability, immediate rescue PCI should be performed. All other patients should undergo routine cardiac catheterization and PCI within 24 hours after fibrinolysis. A pharmacoinvasive strategy is best implemented within an organized regional STEMI system with prospective standardized transfer protocols.

AB - Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). However, only one-third of hospitals in the US have PCI availability 24/7. For non-PCI hospitals, transfer remains the optimal strategy. For expected delays of greater than 120 minutes, a pharmacoinvasive strategy is recommended. In patients with evidence of failed reperfusion or hemodynamic instability, immediate rescue PCI should be performed. All other patients should undergo routine cardiac catheterization and PCI within 24 hours after fibrinolysis. A pharmacoinvasive strategy is best implemented within an organized regional STEMI system with prospective standardized transfer protocols.

KW - Facilitated PCI

KW - Interhospital transfer

KW - Percutaneous coronary intervention

KW - Pharmacoinvasive

KW - Rural

KW - ST segment elevation myocardial infarction

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Reperfusion Options for ST Elevation Myocardial Infarction Patients with Expected Delays to Percutaneous Coronary Intervention

Abstract

Bibliographical note

Keywords

UN SDGs

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