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Expanding the Access to Percutaneous Coronary Intervention for Patients Admitted to Community Hospitals

  • Chapter
Management of Acute Coronary Syndromes

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Interventional therapy is now central to the treatment of patients with acute coronary artery syndromes (ACS): acute ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). Most patients with acute myocardial infarction (AMI), however, present to community hospitals that do not have cardiac surgical programs, and thus usually lack the capability to provide percutaneous coronary intervention (PCI) (1). The requirement that PCI be provided only at tertiary cardiac surgery centers has thus limited the widespread application of this optimal therapy for ACS. Extending the benefits of early PCI to this large population of patients with ACS that are admitted to community hospitals requires either transfer to a tertiary surgery center, often emergently, or the performance of PCI on site. A third solution is the ambulance triage of patients with AMI to emergency intervention centers if within a reasonable distance; this is not yet an acceptable practice in most regions of the United States.

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Authors
  1. Thomas P. Wharton Jr.
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  2. Nancy Sinclair McNamara
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Editors and Affiliations

  1. Cardiovascular Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Christopher P. Cannon MD (Associate Professor of Medicine) (Associate Professor of Medicine)

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Wharton, T.P., McNamara, N.S. (2003). Expanding the Access to Percutaneous Coronary Intervention for Patients Admitted to Community Hospitals. In: Cannon, C.P. (eds) Management of Acute Coronary Syndromes. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-351-4_11

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  • DOI: https://doi.org/10.1007/978-1-59259-351-4_11

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