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Time Is of the Essence

Rita F. Redberg, MD, MSc, Editor

Arch Intern Med. 2012;172(2):98-99. doi:10.1001/archinternmed.2011.566

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

For patients presenting with acute ST-segment elevation myocardial infarction (STEMI), timely reperfusion is a life-saving treatment. The benefit is closely related to rapidity of reperfusion, as "time is muscle." Studies showing that primary percutaneous coronary intervention (pPCI) has a mortality advantage over thrombolytics¹ have led to its dominance as the preferred revascularization strategy in the United States. Furthermore, older data² showing improvement in outcomes for patients with STEMI receiving pPCI even when this requires transfer to another facility, instead of thrombolysis, have led to the adoption of the "transfer for PCI" strategy, if transfer can be accomplished in a timely fashion. However, this remains a big "if."

Primary PCI is resource intensive and therefore not widely available. Of the nearly 5000 acute care hospitals in the United States, less than one-fourth have PCI capability and even less can provide 24-hours-per-day, 7-days-per-week (24/7) PCI.³ Although . . . [Full Text of this Article]

AUTHOR INFORMATION
Author Affiliation: Department of Medicine, University of California, San Francisco.

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