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This Week in JAMA
April 17, 2002

This Week in JAMA

JAMA. 2002;287(15):1899. doi:10.1001/jama.287.15.1899

Although clinical trials suggest that primary percutaneous coronary intervention (PCI) for the treatment of patients with acute myocardial infarction (MI) is superior to thrombolytic therapy, PCI has generally been limited in clinical trials and in practice to patients treated at hospitals with on-site cardiac surgery. In this randomized trial, Aversano and colleaguesArticle compared PCI and thrombolytic therapy at 11 community hospitals without on-site cardiac surgery or existing PCI programs after first establishing a formal primary PCI program at each hospital. Consistent with results of previous trials, clinical outcomes in patients with acute MI were significantly better at 6 weeks and 6 months after the index MI in the primary PCI group compared with those in the thrombolytic therapy group. In an editorial, CannonArticle discusses the implications of these results for the emergency triage of patients with acute MI.