Narrative review: Reperfusion strategies for ST-segment elevation myocardial infarction

Henry H. Ting, Eric H. Yang, Charanjit S. Rihal

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


Optimal treatment for ST-segment elevation myocardial infarction depends on early diagnosis and rapid selection of the appropriate reperfusion strategy. Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy at PCI-capable hospitals. For hospitals without PCI capability, there are 2 reperfusion strategies, primary PCI and thrombolytic therapy, which are both supported by clinical evidence and national guidelines. Transferring patients for primary PCI may cause delays and requires established, proven protocols, systems, and networks to achieve minimal door-to-balloon times. The authors review the available data and present a systematic, evidence-based approach in a simple framework to enable noncardiovascular and cardiovascular physicians to select the optimal reperfusion strategy. The framework is based on available data from clinical trials and local circumstances from clinical practice by incorporating duration of symptoms (fixed ischemia time) and anticipated transport delays to a PCI-capable facility (incurred ischemia time).

Original languageEnglish (US)
Pages (from-to)610-617
Number of pages8
JournalAnnals of internal medicine
Issue number8
StatePublished - Oct 17 2006

ASJC Scopus subject areas

  • Internal Medicine


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