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Invited Commentary
February 2015

Is Primary Percutaneous Coronary Intervention Still the Superior Reperfusion Strategy?

Author Affiliations
  • 1Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
JAMA Intern Med. 2015;175(2):216-217. doi:10.1001/jamainternmed.2014.6586

The current guidelines for the management of ST-segment elevation myocardial infarction (STEMI) recommend primary percutaneous coronary intervention (pPCI) as the preferred treatment strategy if it can be conducted in a timely fashion by an experienced catheterization team.1 Because of the restricted availability of hospitals providing pPCI support 24 hours 7 days a week, the concept of STEMI networks with prearranged rapid transfer protocols between community hospitals and PCI-capable centers has been developed. The goal is to offer pPCI, which is currently considered the superior reperfusion therapy, to a maximum number of patients with STEMI. Although initial experiences with local STEMI networks were encouraging, the transition from thrombolysis to PCI for patients admitted to community hospitals requires close follow-up because changes in delays may offset the benefit of pPCI over thrombolysis.

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