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April 18, 1977

Intermediate Coronary Care Units

JAMA. 1977;237(16):1697-1698. doi:10.1001/jama.1977.03270430039014

CORONARY care units have functioned since 1962,1 and despite some contrary views,2 most physicians agree that they reduce the mortality from acute myocardial infarction if the patient survives long enough to be admitted. The mortality during the later in-hospital phase following acute myocardial infarction may, however, be as high as that within the unit itself,3 and, in consequence, Gotsman and Shrire4 proposed setting up an intermediate coronary care unit (ICCU) to provide the patient continued and progressive coronary care after he had left the coronary care unit (CCU). By 1971 Grace and Yarvote5 began routinely monitoring patients beyond the fifth hospital day in a specially equipped and staffed area separate from the CCU, and Whipple et al6 were also early in developing dedicated units of this type.

It seems reasonable, therefore, that when considering appropriate management for patients suffering coronary heart disease, we should