In centers without available cath labs, it is unclear how quickly patients need to be transferred for PCI after fibrinolysis. In this trial of 1059 patients with STEMI, after fibrinolysis, they were randomized to immediate transfer for PCI (in <6 hours) or standard therapy (transfer for rescue PCI or angiography >24 hours). Most patients received catheterization (98% of the transfer group and 89% of the standard therapy group) at a median time of 3 and 32 hours, respectively. There was a significant reduction of the 30 day primary outcome (death, reinfarction, recurrent ischemia, or new/worse CHF) in the early treatment group (11% versus 17%). Every effort should be made to transfer patients for catheterization after fibrinolysis in STEMI (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.