Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: The Commentary on regionalization
of care for acute coronary syndromes (ACS) by Mr Rathore and colleagues1 did not directly address the most important advantage
of transporting patients to hospitals with percutaneous coronary intervention
(PCI) capability. The focus should not be the broad condition of ACS, but
rather the individual patient with ST-elevation myocardial infarction (STEMI).
Primary studies and quantitative reviews show that, for STEMI patients, PCI
improves outcomes compared with intravenous fibrinolytic therapy.2 This is especially true for the combined end point
of death, recurrent ischemia, or stroke, even in hospitals with new PCI programs
using higher volume operators.3
Haynes BE. Acute Coronary Syndromes and Regionalization of Care. JAMA. 2005;294(3):304-305. doi:10.1001/jama.294.3.304-a