Interventional management of acute coronary syndromes: applying the lessons of ST-elevation services to non-ST-elevation myocardial infarction.
Many countries have embarked on national strategies to translate evidence from trials of reperfusion therapy for ST-elevation myocardial infarction (STEMI) into clinical practice. Primary angioplasty has become the dominant mode of reperfusion, but the best outcomes depend on appropriate service re-configurations to ensure rapid, effective and comprehensive treatment. Although there are many differences in the treatment of STEMI and non-STEMI acute coronary syndromes (ACS), there are many parallels. Many of the changes in the system of care for STEMI patients could now be applied to the non-STEMI ACS population, providing faster and more efficient care and promising to deliver better outcomes. This article highlights additional changes to healthcare services that should be considered.
Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK. mark.debelder@stees.nhs.uk
Mark A
MA
de Belder
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000191:economics; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000592:standards; D042241:Early Diagnosis; D019317:Evidence-Based Medicine; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000191:economics / Q000592:standards; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D016896:Treatment Outcome