TY - JOUR
T1 - Implementation of Regional ST-Segment Elevation Myocardial Infarction Systems of Care
T2 - Successes and Challenges
AU - Fordyce, Christopher B.
AU - Henry, Timothy D.
AU - Granger, Christopher B.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Current guidelines recommend that communities create and maintain a regional system of ST-segment elevation myocardial infarction (STEMI) care that includes assessment and continuous quality improvement of emergency medical services and hospital-based activities. Availability and timely access is a challenge in many areas of the United States. This article reviews clinical trial data supporting the use of primary percutaneous coronary intervention as the optimal reperfusion strategy, and fibrinolysis as an option when this is not possible. It then describes the outcomes and benefits of implementing regional systems of STEMI care, and discusses ongoing challenges for STEMI system implementation, including inadequate data collection and feedback, and hospital and physician competition.
AB - Current guidelines recommend that communities create and maintain a regional system of ST-segment elevation myocardial infarction (STEMI) care that includes assessment and continuous quality improvement of emergency medical services and hospital-based activities. Availability and timely access is a challenge in many areas of the United States. This article reviews clinical trial data supporting the use of primary percutaneous coronary intervention as the optimal reperfusion strategy, and fibrinolysis as an option when this is not possible. It then describes the outcomes and benefits of implementing regional systems of STEMI care, and discusses ongoing challenges for STEMI system implementation, including inadequate data collection and feedback, and hospital and physician competition.
KW - Emergency medical services
KW - Primary percutaneous coronary intervention
KW - Reperfusion
KW - ST-segment elevation myocardial infarction
KW - Systems
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U2 - 10.1016/j.iccl.2016.06.001
DO - 10.1016/j.iccl.2016.06.001
M3 - Review article
C2 - 28581992
AN - SCOPUS:84981747406
SN - 2211-7458
VL - 5
SP - 415
EP - 425
JO - Interventional Cardiology Clinics
JF - Interventional Cardiology Clinics
IS - 4
ER -