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Review
. 2006 Mar 1;22(3):243-50.
doi: 10.1016/s0828-282x(06)70904-7.

Delivery of primary percutaneous coronary intervention for the management of acute ST segment elevation myocardial infarction: summary of the Cardiac Care Network of Ontario Consensus Report

Marino Labinaz  1 , Terri Swabey, Randal Watson, Madhu Natarajan, Wendy Fucile, Bruce Lubelsky, Bruce Sawadsky, Eric Cohen, Kevin Glasgow; CCN Consensus Panel on Access to Urgent PCI for ST Segment Elevation Myocardial Infarction
Affiliations
Review

Delivery of primary percutaneous coronary intervention for the management of acute ST segment elevation myocardial infarction: summary of the Cardiac Care Network of Ontario Consensus Report

Marino Labinaz et al. Can J Cardiol. .

Abstract
in English, French

Tremendous debate has developed over the efficacy of primary percutaneous coronary intervention (PCI) compared with fibrinolysis as the preferred treatment for acute ST segment elevation myocardial infarction (STEMI). In 2002, the Ontario Ministry of Heath and Long-Term Care commissioned the Cardiac Care Network of Ontario to develop consensus recommendations regarding the provincial coordination and provision of urgent PCI for STEMI patients. The panel's work has provided important insights into the acute treatment of STEMI that may be useful to other jurisdictions and may provide a reference for other regions considering the implementation of primary PCI for the management of STEMI patients in their community. In the present report, the evidence for primary PCI is reviewed, the important barriers to implementing this strategy are summarized and several recommendations and models of care for the delivery of primary PCI for STEMI on a wide scale are presented.

Une énorme controverse a été soulevée sur l’efficacité de l’intervention coronaire percutanée (ICP) primaire par rapport à la fibrinolyse comme traitement de choix de l’infarctus du myocarde par surélévation aiguë du segment ST (IMSST). En 2002, le ministère de la Santé et des Soins de longue durée de l’Ontario a demandé au Réseau des soins cardiaques de l’Ontario d’élaborer des recommandations consensuelles quant à la coordination et aux dispositions provinciales en matière d’ICP urgentes pour les patients atteints d’un IMSST. Les travaux du réseau ont donné d’importants aperçus du traitement aigu de l’IMSST qui pourraient être utiles dans d’autres territoires et servir de référence à d’autres régions envisageant l’implantation d’ICP primaires pour prendre en charge les patients atteints d’un IMSST dans leur collectivité. Dans le présent compte rendu, les données justifiant une ICP primaire sont analysées, les principaux obstacles à l’implantation de cette stratégie sont résumés et plusieurs recommandations et modèles de soins à large échelle sont présentés pour la prestation d’ICP primaires en cas d’IMSST.

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Figures

Figure 1)
Figure 1)
Acute care hospitals and communities within a 90-min ‘door-to-balloon time’ of a percutaneous coronary intervention (PCI) hospital. Red squares are PCI hospitals, green squares are acute care hospitals and blue shaded areas are areas within 30±5 min from a PCI hospital
See this image and copyright information in PMC

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