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June 14, 2000

Primary Angioplasty—Time Is of the Essence

Author Affiliations

Author Affiliation: Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio.

JAMA. 2000;283(22):2988-2989. doi:10.1001/jama.283.22.2988

Twelve years ago, Ellwood1 described "a technology of experience" by which observational databases would be used to learn about how best to improve implementation of medical interventions. Ellwood envisioned a unified national database containing information on all facets of patient care. Researchers and decision makers would have the ability to analyze relevant data to answer questions of interest. Although a single national database of this kind has not been realized, a number of very large registries have been successfully assembled and used to learn about important associations between treatments and outcomes.2 In this issue of THE JOURNAL, Cannon et al3 report on the relation between speed of performing primary angioplasty and in-hospital mortality among patients with acute myocardial infarction. Taking advantage of a multicenter database containing information about more than 750,000 patients, the authors focused on 27,080 patients who presented with ST-segment elevation or left bundle-branch block and who were treated with primary angioplasty.

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