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Recent articles have focused attention on strategies to reduce door-to-balloon times for patients with ST-segment-elevation MI (STEMI) who undergo percutaneous coronary intervention. Patients who require interhospital transfer for PCI are the most susceptible to long delays; thus, regionalization strategies may increase the number of patients who can undergo primary PCI but may also lengthen the time to treatment.
The city of Ottawa implemented an integrated metropolitan-area approach in which all patients with STEMI are referred to a single cardiac care center for primary PCI. From May 2005 through April 2006, 344 patients with STEMI were referred to the regional center: 135 directly from the field by paramedics and 209 from hospital emerge…