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Van Brabandt and Vrijens and Yan and colleagues suggest that the differences in outcomes for patients admitted to hospitals with vs without PCI facilities in the Unité de Soins Intensifs Coronaires (USIC) 2000 study1 can be explained by different rates of reperfusion therapy (primary PCI or thrombolysis) rather than PCI within 48 hours of admission. Actually, identifying the individual effects of reperfusion therapy, primary PCI, and PCI within 48 hours of admission on 1-year survival is challenging because of the high degree of correlation between these variables.
Labarere J, Belle L, Danchin N. Better Outcome of Myocardial Infarction in Hospitals With PCI Facilities—Is It Because of More PCIs?—Reply. Arch Intern Med. 2008;168(2):240-241. doi:10.1001/archinternmed.2007.45