PMID- 28581994 OWN - NLM STAT- MEDLINE DCOM- 20181018 LR - 20220408 IS - 2211-7466 (Electronic) IS - 2211-7458 (Linking) VI - 5 IP - 4 DP - 2016 Oct TI - Reperfusion Options for ST Elevation Myocardial Infarction Patients with Expected Delays to Percutaneous Coronary Intervention. PG - 439-450 LID - S2211-7458(16)30059-1 [pii] LID - 10.1016/j.iccl.2016.06.004 [doi] AB - Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). However, only one-third of hospitals in the US have PCI availability 24/7. For non-PCI hospitals, transfer remains the optimal strategy. For expected delays of greater than 120 minutes, a pharmacoinvasive strategy is recommended. In patients with evidence of failed reperfusion or hemodynamic instability, immediate rescue PCI should be performed. All other patients should undergo routine cardiac catheterization and PCI within 24 hours after fibrinolysis. A pharmacoinvasive strategy is best implemented within an organized regional STEMI system with prospective standardized transfer protocols. CI - Copyright (c) 2016 Elsevier Inc. All rights reserved. FAU - Larson, David M AU - Larson DM AD - University of Minnesota Medical School, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, 920 East 28th Street, Suite 100, Minneapolis, MN 55407, USA; Division of Cardiology, Ridgeview Medical Center, 500 South Maple Street, Waconia, MN 55387, USA. Electronic address: david.larson@ridgeviewmedical.org. FAU - McKavanagh, Peter AU - McKavanagh P AD - Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada. FAU - Henry, Timothy D AU - Henry TD AD - Division of Cardiology, Cedars-Sinai Heart Institute, 127 South San Vicente Boulevard, Suite A3100, Los Angeles, CA 90048, USA. FAU - Cantor, Warren J AU - Cantor WJ AD - Division of Cardiology, Southlake Regional Health Center, 596 Davis Drive, Newmarket, ON L3Y 2P9, Canada; Department of Medicine, University of Toronto, 27 King's College Circle, Toronto, ON M5S, Canada. LA - eng PT - Journal Article PT - Review DEP - 20160908 PL - Netherlands TA - Interv Cardiol Clin JT - Interventional cardiology clinics JID - 101615153 RN - 0 (Fibrinolytic Agents) SB - IM MH - Fibrinolysis MH - Fibrinolytic Agents/therapeutic use MH - *Health Services Accessibility MH - Humans MH - *Percutaneous Coronary Intervention/methods MH - Prospective Studies MH - *Reperfusion MH - ST Elevation Myocardial Infarction/*therapy MH - Thrombolytic Therapy/methods OTO - NOTNLM OT - Facilitated PCI OT - Interhospital transfer OT - Percutaneous coronary intervention OT - Pharmacoinvasive OT - Rural OT - ST segment elevation myocardial infarction EDAT- 2017/06/06 06:00 MHDA- 2018/10/20 06:00 CRDT- 2017/06/06 06:00 PHST- 2017/06/06 06:00 [entrez] PHST- 2017/06/06 06:00 [pubmed] PHST- 2018/10/20 06:00 [medline] AID - S2211-7458(16)30059-1 [pii] AID - 10.1016/j.iccl.2016.06.004 [doi] PST - ppublish SO - Interv Cardiol Clin. 2016 Oct;5(4):439-450. doi: 10.1016/j.iccl.2016.06.004. Epub 2016 Sep 8.