Reasons for Delays in Transfer of STEMI Patients for PCI

In the U.S., fewer than 10% of transferred patients with ST-segment-elevation myocardial infarction (STEMI) receive percutaneous coronary intervention (PCI) within 90 minutes (the American Heart Association guideline), and only 15% to 35% are treated within 120 minutes (the European Society of Cardiology guideline). The reasons for delay have not previously been described. Researchers examined records for 2034 patients who were transferred for PCI from 31 hospitals in the Minneapolis regional STEMI system during 2003 through 2009. Initially, the target total door-to balloon time was ≤90 minutes, but delays in awaiting transport made this unrealistic, and the researchers changed to ≤120 minutes (45 at the referral center, 45 for transport, a…