Missed Opportunities for STEMI Intervention

More than 20% of eligible STEMI patients did not receive reperfusion therapy, even though most had clear clinical indications for reperfusion.

Prior studies have documented that 20% to 30% of patients with ST-segment-elevation myocardial infarction (STEMI) who are eligible for reperfusion do not receive evidence-based therapy. These authors sought to identify reasons why eligible patients do not receive this potentially life-saving intervention. They retrospectively reviewed the medical records of patients who presented to five Kaiser Permanente–affiliated emergency departments in California and Colorado from 2000 to 2002 with STEMI or new (or not known to be old) left bundle branch block (LBBB) who did not have contraindications to either fibrinolysis or percutaneous coronary intervention (Journal Watch Emergency Medicine Nov 9 2006).

Of 460 patients, 102 (22%) did not receive rep…

Reviewing Author

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