Review Evaluates Systems of Care for STEMI Patients

State-of-the-art paper suggests organization of networks optimizes patient care, but barriers exist
By Rick Ansorge
HealthDay Reporter

THURSDAY, Oct. 22 (HealthDay News) -- In Europe and North America, improvements in systems of care may improve outcomes in patients with ST-segment elevation myocardial infarction (STEMI), according to a state-of-the-art paper published in the October issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

Nicolas Danchin, M.D., of Hopital Europeen Georges Pompidou of Paris reviewed systems of care in Europe and North America, and describes various clinical experiences with network implementation.

The author states that the most effective strategy would be to organize networks based on the use of both primary percutaneous coronary intervention (PCI) and pharmacoinvasive therapy to ensure that most patients in large institutions were treated with primary PCI within reasonable time limits, and that patients living some distance from PCI centers were first treated with fibrinolysis.

"In countries such as the United States, the existence of competing hospital systems might constitute a barrier to the implementation of optimal systems of care for the population, because there might be more financial incentive within a hospital system to have institutions providing more costly technology -- such as PCI -- even if these do not constitute the best medical option," the author writes.

The author reported financial relationships with several pharmaceutical companies.

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