{"id":1563,"date":"2010-06-25T09:45:58","date_gmt":"2010-06-25T13:45:58","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/start-the-timer\/"},"modified":"2011-07-19T17:44:17","modified_gmt":"2011-07-19T21:44:17","slug":"start-the-timer","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2010\/06\/25\/start-the-timer\/","title":{"rendered":"Start The Timer!"},"content":{"rendered":"<p>In a province-wide <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/abstract\/303\/21\/2148\">evaluation of STEMI care in Quebec<\/a>,\u00a0primary PCI was the preferred method of reperfusion therapy: 80% of patients who underwent reperfusion received primary PCI, whereas 20% were given fibrinolytic therapy.<\/p>\n<p>Disappointingly, PCI was performed &gt; 90 minutes after presentation in 68% of recipients; fibrinolysis was performed &gt;30 minutes in 54%.\u00a0<strong><em>Time to reperfusion had a stronger effect on outcomes than the method of reperfusion.<\/em><\/strong> Transfer from a non-PCI center to a hospital with PCI capability was strongly associated with delayed reperfusion (odds ratio, 4.6), which translated to a higher risk of death at 30 days and higher risk of the combined outcome of death of hospital readmssion for CHF or MI at 1 year.<\/p>\n<p>These data suggest that\u00a0<a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/jwatch\/cardiology\/content\/full\/2010\/623\/2\">timely fibrinolysis may be more effective than delayed primary PCI<\/a> in some situations.<\/p>\n<p>If you presented to a non-PCI hospital with an STEMI, would you prefer immediate fibrinolysis or transfer to a PCI-capable facility?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In a province-wide evaluation of STEMI care in Quebec,\u00a0primary PCI was the preferred method of reperfusion therapy: 80% of patients who underwent reperfusion received primary PCI, whereas 20% were given fibrinolytic therapy. Disappointingly, PCI was performed &gt; 90 minutes after presentation in 68% of recipients; fibrinolysis was performed &gt;30 minutes in 54%.\u00a0Time to reperfusion had [&hellip;]<\/p>\n","protected":false},"author":214,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,9],"tags":[],"class_list":["post-1563","post","type-post","status-publish","format-standard","hentry","category-general","category-interventional-cardiology"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/1563","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/214"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=1563"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/1563\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=1563"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=1563"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=1563"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}