PMID- 19444405
OWN - NLM
STAT- MEDLINE
DCOM- 20090805
LR  - 20211020
IS  - 1615-6692 (Electronic)
IS  - 0340-9937 (Linking)
VI  - 34
IP  - 3
DP  - 2009 May
TI  - [Acute myocardial infarction: acute coronary intervention at any hospital versus 
      acute coronary intervention at specialized centers only].
PG  - 211-7
LID - 10.1007/s00059-009-3230-9 [doi]
AB  - The acute coronary syndromes (ACS) are currently divided into those with ST 
      elevation (STE-ACS = ST elevation myocardial infarction [STEMI]) and those 
      without ST elevation (NSTE-ACS). The latter are further divided into NSTE-ACS 
      with risk factors and NSTE-ACS without risk factors. For NSTE-ACS patients with 
      risk factors an invasive strategy within 72 h after presentation is recommended, 
      whereas NSTE-ACS patients without risk factors can be treated conservatively, 
      without a routine invasive diagnosis. In patients with STE-ACS, primary 
      angioplasty is the reperfusion therapy of choice. These recommendations 
      concerning the invasive strategies are valid only under three conditions: (1) 
      primary angioplasty has to be performed within 2 h after diagnosis of an STE-ACS; 
      (2) door-to-balloon times for STE-ACS have to be < 60 min; (3) the invasive 
      procedures have to be performed by experienced investigators at hospitals with a 
      sufficient annual PCI (percutaneous coronary intervention) volume. The last point 
      is based on studies which showed a volume-outcome relationship for PCIs in ACS 
      patients and hospital mortality. In Germany, a nationwide supply with such an 
      invasive strategy for ACS patients is currently possible, even within the 
      recommended time frames. Therefore, local networks have to be established to 
      achieve this goal. However, at least in regions with a high density of invasive 
      centers, such networks should take the investigators' experience and the annual 
      interventional volumes of the participating hospitals into account.
FAU - Zahn, Ralf
AU  - Zahn R
AD  - Chefarzt der Medizinischen Klinik B, 
      Kardiologie/Pneumologie/Angiologie/Internistische Intensivmedizin, Herzzentrum 
      Ludwigshafen, Bremserstrasse 79, 67063 Ludwigshafen. erzahn@aol.com
FAU - Zeymer, Uwe
AU  - Zeymer U
LA  - ger
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Akuter Myokardinfarkt: Akut-PCI in jedem Krankenhaus versus Akut-PCI im 
      spezialisierten Zentrum.
PL  - Germany
TA  - Herz
JT  - Herz
JID - 7801231
SB  - IM
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - Hospitalization/*trends
MH  - Humans
MH  - Myocardial Infarction/*surgery
MH  - *Specialization
MH  - Treatment Outcome
RF  - 57
EDAT- 2009/05/16 09:00
MHDA- 2009/08/06 09:00
CRDT- 2009/05/16 09:00
PHST- 2009/05/16 09:00 [entrez]
PHST- 2009/05/16 09:00 [pubmed]
PHST- 2009/08/06 09:00 [medline]
AID - 10.1007/s00059-009-3230-9 [doi]
PST - ppublish
SO  - Herz. 2009 May;34(3):211-7. doi: 10.1007/s00059-009-3230-9.