This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content

(Circulation. 2005;111:717.)
© 2005 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	TIMES TO TREATMENT IN TRANSFER PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN THE UNITED STATES: NATIONAL REGISTRY OF MYOCARDIAL INFARCTION (NRMI)-3/4 ANALYSIS, by Nallamothu et al.

 
Primary percutaneous coronary angioplasty (PCI) has emerged as an attractive alternative reperfusion strategy for myocardial infarction (MI), and recent trials indicate it may be superior to fibrinolysis. However, PCI may necessitate transfer of MI patients to hospitals with such capabilities, and the inherent delay due to transfer may mitigate potential benefits. In this issue of Circulation, Nallamothu and colleagues analyze data from the National Registry of Myocardial Infarction to assess the time to PCI in more than 4000 patients treated at 419 hospitals in the United States. The investigators report that the "door-to-balloon" time was 180 minutes (twice the recommended standard) in 50 percent of the patients; fewer than 5 percent were treated within 90 minutes. Presence of comorbidity, nonclassical presentation, and rural location of the treating hospital were key correlates of longer time to PCI. The authors emphasize the need for improved process-of-care systems to maximize the therapeutic benefits of PCI in MI patients. See p 761.

	RISK OF RESTENOSIS AND HEALTH STATUS OUTCOMES FOR PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION VERSUS CORONARY ARTERY BYPASS GRAFT SURGERY, by Spertus et al.

 
Most studies comparing bypass surgery (CABG) to percutaneous coronary intervention (PCI) have found similar outcomes with regard to death and myocardial infarction but more angina and need for repeat revascularization procedures after PCI, presumably because of restenosis. In this report, Spertus et al demonstrate a correlation between preprocedural restenosis risk (as measured by a scoring system they previously developed) and health outcome at follow-up. Administering the Seattle Anginal Questionnaire to 1469 patients undergoing CABG or PCI, they found no differences in 1-year angina or quality of life among the 37.4% of . . . [Full Text of this Article]