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Previous Volume 357:1631-1638 October 18, 2007 Number 16 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Early administration of reperfusion therapy improves survival in patients with ST-elevation myocardial infarction by reestablishing coronary blood flow within the occluded infarct-related artery.¹ Primary percutaneous coronary intervention (PCI) is superior to fibrinolytic therapy when performed rapidly by expert teams,² but its effectiveness may be limited by delays in delivery.³

Recent national efforts are drawing attention to the importance of door-to-balloon time as a key indicator of quality of care for patients with ST-elevation myocardial infarction who are treated with primary PCI.⁴ The American College of Cardiology (ACC), in collaboration with the American Heart Association (AHA), the American College of Emergency . . . [Full Text of this Article]

Pathophysiology of Myocardial Necrosis

Fibrinolytic Therapy

Primary PCI

Performance with Respect to Door-to-Balloon Time

Selecting a Reperfusion Therapy

Reducing Door-to-Balloon Time

Combination Strategies

Future Challenges in Improving Time to Treatment in Primary PCI

Source Information

From the Health Services Research and Development Center of Excellence, Ann Arbor Veterans Affairs Medical Center, and the Department of Internal Medicine, Division of Cardiovascular Disease, University of Michigan Medical School — both in Ann Arbor (B.K.N.); the Section of Health Policy and Administration, Department of Epidemiology and Public Health and the Robert Wood Johnson Clinical Scholars Program, Department of Medicine, Yale University School of Medicine, New Haven, CT (E.H.B., H.M.K.); and the Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, and the Center for Outcomes Research and Evaluation, Yale–New Haven Hospital — both in New Haven, CT (H.M.K.).

Address reprint requests to Dr. Krumholz at 333 Cedar St., Rm. I-456 SHM, P.O. Box 208088, New Haven, CT 06520-8088, or at harlan.krumholz@yale.edu.

Related Letters:

Primary Percutaneous Coronary Intervention
Kapoor R., Kapoor J. R., Gurewich V., Szabo S., Oikonomopoulos T., Hoffmeister H. M., Nallamothu B. K., Bradley E. H., Krumholz H. M.
Extract | Full Text | PDF  
N Engl J Med 2008; 358:431-433, Jan 24, 2008. Correspondence

This article has been cited by other articles:

• Terkelsen, C. J., Lassen, J. F. (2008). Treatment delays in ST elevation myocardial infarction. BMJ 336: 401-402 [Full Text]  
• Vetrovec, G. W. (2008). Improving Reperfusion in Patients with Myocardial Infarction. NEJM 358: 634-637 [Full Text]  
• Kapoor, R., Kapoor, J. R., Gurewich, V., Szabo, S., Oikonomopoulos, T., Hoffmeister, H. M., Nallamothu, B. K., Bradley, E. H., Krumholz, H. M. (2008). Primary Percutaneous Coronary Intervention. NEJM 358: 431-433 [Full Text]