April 1, 2003The American Heart Hospital Journal
The Level I Cardiovascular Center: Is It Time?
Key result
Prehospital partial dose thrombolysis followed by immediate transport to a Level I cardiovascular center is proposed to reduce ST-elevation AMI mortality from 6%-10% to less than 4%.
Why the study?
Does prehospital partial dose thrombolysis followed by immediate transport to a Level I cardiovascular center reduce mortality in patients with ST-elevation AMI?
Population
Patients with ST-segment elevation acute myocardial infarction (AMI) in the United States
Comparison
Prehospital, partial dose thrombolysis followed… vs Current standard of care
Design
Editorial
Authors
Discussion
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Member takes
Implication
Proposes the establishment of Level I Cardiovascular Centers and a prehospital facilitated PCI strategy to reduce AMI mortality, calling for validation via the proposed PATCAR trial.
Structured PICO
Does prehospital partial dose thrombolysis followed by immediate transport to a Level I cardiovascular center reduce mortality in patients with ST-elevation AMI?
P
Population
Patients with ST-segment elevation acute myocardial infarction (AMI) in the United States
I
Intervention
Prehospital, partial dose thrombolysis followed by immediate transport to a Level I cardiovascular center (bypassing the closest hospital if necessary) for facilitated infarct-related artery PCI
C
Comparator
Current standard of care (transport to nearest hospital)
O
Outcome
Mortalityhard clinical
Proposes the establishment of Level I Cardiovascular Centers and a prehospital facilitated PCI strategy to reduce AMI mortality, calling for validation via the proposed PATCAR trial.
Cite This Study
Smalling et al. (2003) conducted an editorial in Acute myocardial infarction (AMI). Prehospital partial dose thrombolysis and immediate transport to a Level I cardiovascular center was evaluated. Prehospital partial dose thrombolysis followed by immediate transport to a Level I cardiovascular center is proposed to reduce ST-elevation AMI mortality from 6%-10% to less than 4%.