August 17, 2004Annals of Internal Medicine
Primary Percutaneous Coronary Intervention for Every Patient with ST-Segment Elevation Myocardial Infarction: What Stands in the Way?
Why the study?
Does primary PCI improve clinical outcomes compared to thrombolytic therapy in patients with ST-segment elevation MI, and how can it be universally implemented?
Population
Patients with ST-segment elevation myocardial infarction (STEMI)
Comparison
Primary percutaneous coronary intervention (PCI) vs Thrombolytic therapy
Design
Review
Authors
Discussion
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Member takes
Implication
Supports regional STEMI networks; extends RCT evidence toward universal primary PCI access.
Structured PICO
Does primary PCI improve clinical outcomes compared to thrombolytic therapy in patients with ST-segment elevation MI, and how can it be universally implemented?
P
Population
Patients with ST-segment elevation myocardial infarction (STEMI)
I
Intervention
Primary percutaneous coronary intervention (PCI)
C
Comparator
Thrombolytic therapy
O
Outcome
Mortalityhard clinical
The authors propose systemic strategies, such as regional PCI centers and inter-hospital transfers, to overcome obstacles to the universal availability of primary PCI for STEMI.
Cite This Study
Keeley et al. (2004) studied this question.