Regionally Coordinated Systems of Care for Patients with STEMI

Two studies suggest that in coordinated regionalized systems, patient transfer to PCI centers is safe and reduces time to treatment.

Primary percutaneous coronary intervention (PCI), if performed within 90 minutes, is the preferred method of reperfusion in patients with ST-segment-elevation myocardial infarction (STEMI). However, only 25% of U.S. hospitals have PCI capability. Unfortunately, few regions have a coordinated and efficient method for rapidly referring patients to PCI centers to obtain optimal therapy. Two recent trials report that simple strategies can reduce time to PCI.

Researchers evaluated the effect of the Mayo Clinic STEMI protocol on door-to-treatment time. The protocol involved strategies for coordinating a regional system of care involving a PCI center and 28 regional hospitals; for optimizing process, referral, and transport mechanisms; and for redu…

Reviewing Author

Aaron E. Bair, MD, MSc, FAAEM, FACEP