To the Editor: The recommendation for managing acute ST-segment-elevation myocardial infarction with percutaneous coronary intervention (PCI) is that the door-to-balloon inflation time should be 90 minutes. However, it can be up to 120 minutes, depending on when patients present to the emergency department (ED) after the onset of their symptoms.1 In such cases, an alternative immediate reperfusion strategy — fibrinolysis — should be considered.
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- Angliss Hospital, Melbourne, VIC.
- 1. Acute Coronary Syndrome Guidelines Working Group. Guidelines for the management of acute coronary syndromes 2006. Med J Aust 2006; 184 (8 Suppl): S1-S32. <MJA full text>
- 2. 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.
- 3. Anderson HR, Neilsen TT, Rasmussen K, et al. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. N Engl J Med 2003; 349: 733-742.
- 4. NRMI 4 Investigators. The National Registry of Myocardial Infarction 4 quarterly data report. South San Francisco, Calif: Genentech, March 2003.