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December 27, 2000

Volume-Outcome Relationship in Acute Myocardial InfarctionThe Balloon and the Needle

Author Affiliations

Author Affiliations: Clinical Research Institute, Duke University Medical Center, Durham, NC (Dr Jollis); Division of General Medicine, University of California, Davis, Sacramento (Dr Romano).

JAMA. 2000;284(24):3169-3171. doi:10.1001/jama.284.24.3169

In this issue of THE JOURNAL, McGrath and colleagues1 and Magid and colleagues2 examine 2 of the most contentious issues in the provision of cardiac care: the relationship between experience and outcome for percutaneous interventions, and the superiority of percutaneous revascularization (eg, primary angioplasty or other procedures) relative to thrombolytic therapy for acute myocardial infarction (AMI). These 2 issues lead to the question of whether primary angioplasty can be effectively performed in low-volume hospitals and by low-volume physicians. Supporters of both primary angioplasty and volume standards will no doubt refer to these works in their future deliberations.

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