Regulatory Changes for the Treatment of Patients With Heart Attacks

Steinbuch, Robert

doi:10.1016/j.amjcard.2006.11.045

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…Allowing direct transportation of patients to a PCI centre by bypassing a community hospital has decreased on the one hand regulatory problems, but also increased the fear of loss of competence of representatives of non-PCI hospitals equipped with coronary care units/intensive care units (CCUs/ICUs). In several European countries, but also in parts of the USA, the law requires patients with acute STEMI to be transferred to the nearest hospital with coronary care and intensive cardiac care facilities, even though the hospital has no pPCI capability 17. Non-PCI hospitals should know and accept that they cannot offer optimal care for STEMI patients with consecutive low cardiovascular morbidity and mortality.…”

Section: The Impact Of Time Delaysmentioning

confidence: 99%

Network models for large cities: the European experience

Huber

Goldstein

Danchin

et al. 2010

Heart

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Section: The Impact Of Time Delaysmentioning

confidence: 99%

Network models for large cities: the European experience

Huber

Goldstein

Danchin

et al. 2010

Heart

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Défis de la prise en charge du syndrome coronaire aigu en pré-hospitalier

Assez

Lemanski-Brulin

Aboukais

et al. 2012

Archives of Cardiovascular Diseases Supplements

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A European perspective on improving acute systems of care in STEMI: we know what to do, but how can we do it?

Fox

Huber

2008

Nat Rev Cardiol

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For the management of ST-segment elevation acute myocardial infarction (STEMI), international guidelines recommend primary percutaneous coronary intervention with adjunctive antithrombotic therapy, the management of complications, and secondary prevention measures. Delivery of care has, however, lagged behind establishing the evidence for effectiveness. Approximately a quarter of all patients with STEMI still fail to receive reperfusion therapy. Additionally, for most patients delays substantially exceed guideline recommendations and secondary prevention is incomplete. What can be done? First, cardiologists need to take the lead in improving systems of care, with the integration of prehospital care within 'heart attack networks' involving intervention centers, nonintervention hospitals, primary care, and paramedic ambulance care. Several examples show that such systems are feasible. 'Door-to-balloon' initiatives can improve care in the final interventional hospital, but only make a modest contribution to total patient delay. Second, high-risk patients, including the elderly and those with cardiac complications like heart failure, should be targeted for more-aggressive interventional and pharmacologic therapy; the opposite situation currently exists in clinical practice (the treatment-risk paradox). Third, greater emphasis on quality improvement, collaboration among health professionals, and achieving high-quality care for all is required from funding bodies, regulatory agencies and professional societies.

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Regulatory Changes for the Treatment of Patients With Heart Attacks

Cited by 4 publications

References 9 publications

Network models for large cities: the European experience

Network models for large cities: the European experience

Défis de la prise en charge du syndrome coronaire aigu en pré-hospitalier

A European perspective on improving acute systems of care in STEMI: we know what to do, but how can we do it?

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