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December 19, 2007

Measuring the Quality of Primary PCI for ST-Segment Elevation Myocardial Infarction: Time for Balance

Author Affiliations

Author Affiliations: Department of Medicine, Division of Cardiology, Denver Health Medical Center, Denver, Colorado; and Department of Medicine, Division of Cardiology, University of Colorado at Denver and Health Sciences Center, Aurora.

JAMA. 2007;298(23):2790-2791. doi:10.1001/jama.298.23.2790

Reperfusion therapy with percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) has understandably received considerable attention in quality measurement and improvement initiatives. STEMI is a common condition with high mortality. The benefits of reperfusion therapy can be substantial but are time sensitive.1 However, important gaps exist between the patterns of treatment in the community and the ideal benchmarks established in evidence-based practice guidelines.2 The timeliness of primary PCI, or “door-to-balloon” time, has emerged as one of a handful of quality measures reported to the public for the care of patients with acute myocardial infarction3 and serves as the focus of both regional4,5 and national initiatives6,7 to improve care quality.