Abstract | PURPOSE OF REVIEW: RECENT FINDINGS: The advantage of transfer for primary PCI (X-PCI) over O-FT was analyzed in a contemporary propensity-score matched cohort by evaluating outcomes based on PCI-related delay (door-to-balloon time minus door-to-needle time). In 19 012 matched STEMI patients from the National Registry of Myocardial Infarction database, the delay to PCI wherein the mortality advantage for X-PCI was nullified compared with O-FT was approximately 120 min. Extensive delays were found to attenuate the mortality benefit of X-PCI [number needed to treat (NNT) 23 for PCI-related delay >60 min; NNT 44 for PCI-related delay 60-90 min; and NNT 250 for PCI-related delay >90 min]. SUMMARY: The benefit of PCI over O-FT appears to markedly decrease as PCI-related delay increases, particularly in the case of interhospital transfer, which can often lead to long reperfusion times. Various strategies can reduce PCI-related delays, including the establishment of STEMI systems of care and regionalization. Furthermore, alternate pharmacoinvasive strategies should be considered when significant delay to PCI is anticipated.
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Authors | Anjan K Chakrabarti, C Michael Gibson, Duane S Pinto |
Journal | Current opinion in cardiology
(Curr Opin Cardiol)
Vol. 27
Issue 6
Pg. 651-4
(Nov 2012)
ISSN: 1531-7080 [Electronic] United States |
PMID | 23032713
(Publication Type: Journal Article, Review)
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Chemical References |
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Topics |
- Fibrinolytic Agents
(therapeutic use)
- Humans
- Myocardial Infarction
(drug therapy, therapy)
- Myocardial Reperfusion
- Patient Transfer
- Percutaneous Coronary Intervention
- Time Factors
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