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Review
. 2014 Jun 26;6(6):424-33.
doi: 10.4330/wjc.v6.i6.424.

Timely reperfusion for ST-segment elevation myocardial infarction: Effect of direct transfer to primary angioplasty on time delays and clinical outcomes

Rodrigo Estévez-Loureiro  1 , Angela López-Sainz  1 , Armando Pérez de Prado  1 , Carlos Cuellas  1 , Ramón Calviño Santos  1 , Norberto Alonso-Orcajo  1 , Jorge Salgado Fernández  1 , Jose Manuel Vázquez-Rodríguez  1 , Maria López-Benito  1 , Felipe Fernández-Vázquez  1
Affiliations
Review

Timely reperfusion for ST-segment elevation myocardial infarction: Effect of direct transfer to primary angioplasty on time delays and clinical outcomes

Rodrigo Estévez-Loureiro et al. World J Cardiol. .

Abstract

Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy for patients presenting with ST-segment elevation myocardial infarction (STEMI) when it can be performed expeditiously and by experienced operators. In spite of excellent clinical results this technique is associated with longer delays than thrombolysis and this fact may nullify the benefit of selecting this therapeutic option. Several strategies have been proposed to decrease the temporal delays to deliver PPCI. Among them, prehospital diagnosis and direct transfer to the cath lab, by-passing the emergency department of hospitals, has emerged as an attractive way of diminishing delays. The purpose of this review is to address the effect of direct transfer on time delays and clinical events of patients with STEMI treated by PPCI.

Keywords: Direct transfer; Myocardial infarction; Primary angioplasty; Primary percutaneous coronary intervention; ST-segment elevation myocardial infarction network.

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Figures

Figure 1
Figure 1
Cox regression survival curves. There is an adjusted survival benefit of direct transfer (DT). With permission, from reference [67]. ED: Emergency department.
Figure 2
Figure 2
Kaplan-Meier survival curves for the different subgroups of higher risk. There is a trend to prognostic benefit in all subgroups that reaches significance in the group of anterior-wall myocardial infarction (MI). With permission, from reference [67]. A: Anterior wall MI; B: Early presenters; C: Diabetic patients; D: Cardiogenic shock. DT: Direct transfer; ED: Emergency department.
See this image and copyright information in PMC

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