Reply to letter to the editor: Revascularization strategy in patients with acute ST-elevation myocardial infarction amid COVID-19 pandemic

Li, Yi Heng; Wang, Mei Tzu; Huang, Wei; Hwang, Juey Jen

doi:10.1016/j.jfma.2020.08.005

Cited by 1 publication

(1 citation statement)

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“…PCI needs to be performed in a timely fashion, and the door-to-balloon (D2B) or door-towire time benchmark is within 60 or 90 minutes, or as short as possible. [1][2][3][4] Many trials have demonstrated that longer D2B delays are associated with larger infarct sizes and higher risks of short-term mortality, increased major adverse cardiovascular events (MACE), higher reinfarction rates, and worse long-term survival. [5][6][7][8] The D2B time has become a performance measure and the focus of regional and national quality improvement initiatives.…”

Section: Timely Reperfusionmentioning

confidence: 99%

Quality care in ST-segment elevation myocardial infarction

Liu

Hung

Chiang

et al. 2022

Journal of the Chinese Medical Association

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Over the past decades, the treatment of ST-segment elevation myocardial infarction (STEMI) has been redefined with the incorporation of evidence from multiple clinical trials. Recommendations from guidelines are updated regularly to reduce morbidity and mortality. However, heterogeneous care systems, physician perspectives, and patient behavior still lead to a disparity between evidence and clinical practice. The quality of care has been established and become an integral part of modern healthcare in order to increase the likelihood of desired health outcomes and adhere to professional knowledge. For patients with STEMI, measuring the quality of care is a multifactorial and multidimensional process that cannot be estimated solely based on patients’ clinical outcomes. The care of STEMI is similar to the concept of “the chain of survival” that emphasizes the importance of seamless integration of five links: early recognition and diagnosis, timely reperfusion, evidence-based medications, control of cholesterol, and cardiac rehabilitation. Serial quality indicators, reflecting the full spectrum of care, have become a widely used tool for assessing performance. Comprehension of every aspect of quality assessment and indicators might be too demanding for a physician. However, it is worthwhile to understand the concepts involved in quality improvement since every physician wants to provide better care for their patients. This article reviews a fundamental approach to quality care in STEMI.

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