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European Heart Journal 2003 24(22):2071; doi:10.1016/j.ehj.2003.05.001
Copyright © 2003 by the European Society of Cardiology.
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Letter to the Editor

Transport for primary PCI in AMI: one-way or roundtrip journey?

Gianni Casella* and Pier Camillo Pavesi

Ospedale Maggiore, Bologna, Italy

* Correspondence to: Dr G. Casella, Department of Cardiology, Ospedale Maggiore, Largo Nigrisoli 2, 40133 Bologna, Italy. +39-0542-26739; fax: +39-051-6478635
E-mail address: gcas{at}fastmail.it

Received 9 March 2003; accepted 23 May 2003

The study of Widimsky et al.,1which appeared recently in the European Heart Journal, clearly support a strategy of long distance transport from community hospitals to tertiary percutaneous coronary intervention centres for intervention in acute myocardial infarction. These data are important and should add substantial changes to the current treatment strategies of acute myocardial infarction worldwide. However, we believe that there is still an unanswered question. What happens to the patient transported to the hub centre after successful percutaneous coronary intervention? Should all patients be observed overnight or 24-h in the interventional centre and then transferred back to the community hospital? Or should all low risk subjects be transported back to the spoke centre immediately? Although this point has not been addressed sufficiently in the literature, it has important clinical, logistic and legal drawbacks both for the percutaneous coronary intervention centre and for the non-interventional hospital. Therefore, we would like to know which policy was applied in the PRAGUE-2 study.

References

  1. Widimsky P, Budesinsky T, Vorac D et al. Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction. Final results of the randomized national multicentre trial-PRAGUE-2. Eur Heart J. 2003;24:94–104.[Abstract/Free Full Text]

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