Fibrinolytic Therapy vs. Primary PCI for STEMI

Transporting STEMI patients directly to specialty centers for primary PCI could offer a survival advantage over transport to local hospitals for fibrinolytic therapy.

The American Heart Association recently changed the guideline for the timing of primary percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction (STEMI) from 120 minutes to 90 minutes after presentation to the emergency department. Arranging for transfer to a PCI-capable hospital and delivery of PCI within the 90-minute window for a STEMI patient who presents to a non–PCI-capable hospital is exceedingly difficult. In an attempt to meet the more aggressive time requirement, some emergency medical services systems have developed primary STEMI point-of-entry protocols for transporting STEMI patients directly to PCI-capable hospitals, even if this means bypassing closer local hospitals.

These authors conducted a de…

Reviewing Author

Richard D. Zane, MD, FAAEM

Disclosures

Nothing to disclose

Richard D. Zane, MD, FAAEM

Disclosures

Nothing to disclose