Should patients with acute ST elevation MI be transferred for primary PCI?

Correspondence to: Dr Steen Dalby Kristensen, Skejby Hospital, DK-8200 Aarhus N, Denmark; [email protected] _________________________ T he treatment strategy for acute myocardial infarction (MI) with ST elevation or newly developed left bundle branch block has been focusing on immediate opening of the infarct related coronary artery. This is because the prognosis for the patient is dependent upon the restoration of coronary flow and myocardial perfusion. Numerous randomised controlled trials with thrombolytic drugs have shown that these drugs can preserve left ventricular function and decrease mortality. Therefore treatment with streptokinase, alteplase, reteplase, and tenecteplase, when administered within 12 hours of onset of symptoms, is given the highest recommendation (IA) in guidelines.