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W. Douglas Weaver, MD

JAMA. 2004;292:2014-2016.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The number of percutaneous coronary intervention (PCI) procedures performed each year has increased substantially, particularly since the introduction of coronary stents. The current increase is being fueled by the shift from thrombolysis to the performance of primary PCI for treatment of acute myocardial infarction (MI). Also, with the availability of drug-eluting stents, patients who previously would not have been eligible for PCI are now candidates for this intervention. The drive to treat patients with acute ST-elevation MI (STEMI) in a timely manner poses the question of whether many more moderate-sized and often suburban hospitals, which in most cases do not have cardiac surgery onsite, should provide primary PCI for patients with STEMI. On the surface, it seems unnecessary to provide surgical backup onsite in such programs because the need for emergency surgery for failed PCI for STEMI is small (1% or less).^1-2 It would seem adequate . . . [Full Text of this Article]

Author Affiliation: Henry Ford Heart & Vascular Institute, Wayne State University, Detroit, Mich.

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