“Time is myocardium” is a concept deeply ingrained in the psyche of all clinicians caring for patients with ST-segment elevation myocardial infarction (STEMI). The widespread adoption of organized systems of care to facilitate timely reperfusion of such patients is undoubtedly one of the great success stories in modern health care delivery. In 2005, fewer than half of patients with STEMI achieved door-to-balloon times (ie, time from hospital arrival to performance of primary angioplasty or balloon inflation) of less than 90 minutes.1 Today, through coordinated efforts by communities, hospitals, professional societies, and government agencies, greater than 95% of patients with STEMI achieve door-to-balloon times within this 90-minute target.2
Yeh RW, Kirtane AJ, Rao SV. Incentivizing Transradial Access for Primary Percutaneous Coronary Intervention While Maintaining Timely Reperfusion. JAMA Cardiol. 2017;2(10):1057–1058. doi:10.1001/jamacardio.2017.2348
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