Time is muscle - Translation into practice
Time is muscle - Translation into practice
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DOI：
10.1016/j.jacc.2008.07.011
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发表时间：
2008-10-07
影响因子：
24
通讯作者：
Antman, Elliott M.
中科院分区：
文献类型：
--
作者：
Antman, Elliott M.
在未来，ST段抬高型心肌梗死（STEMI）患者护理的进步将不会来自对不反映当前实践的试验的分析，以合理延长经皮冠状动脉介入治疗（PCI）相关延迟时间。我们必须超越这些争论，找到缩短总缺血时间的方法。随着美国心脏病学会D2B联盟和美国心脏协会使命：生命线计划的启动，现在的重点是改善STEMI患者的再灌注系统。D2B联盟旨在改善接受直接PCI的STEMI患者的上门球囊扩张时间。美国心脏协会的使命：生命线计划是一项广泛、全面的国家倡议，旨在通过改善医疗保健系统的准备和对STEMI的反应来提高STEMI患者的护理质量和结果。改善ST段抬高型心肌梗死患者获得及时护理的机会需要采取多方面的方法，包括患者教育、改善急诊医疗服务和急诊科护理组成部分、建立ST段抬高型心肌梗死转诊医院网络（不具备PCI能力）和STEMI接收医院（PCI能力），以及协调宣传工作，与付款人和政策制定者合作，实施急需的医疗保健系统重新设计。通过现在专注于改善STEMI及时护理的系统努力，我们将完成Reimer和Jennings 30年前发起的研究周期。时间就是肌肉...我们必须将其付诸实践。
In the future, advances in the care of patients with ST-segment elevation myocardial infarction (STEMI) will not come from the analysis of trials that do not reflect current practice in an effort to rationalize extending the percutaneous coronary intervention (PCI)-related delay time. We must move beyond such arguments and find ways to shorten total ischemic time. With the launching of the American College of Cardiology's D2B Alliance and the American Heart Association's Mission: Lifeline programs, the focus is now on systems improvement for reperfusion in patients with STEMI. The D2B Alliance was developed to focus on improvement in door-to-balloon times for patients with STEMI who are undergoing primary PCI. The American Heart Association Mission: Lifeline program is a broad, comprehensive national initiative to improve the quality of care and outcomes of patients with STEMI by improving health care system readiness and response to STEMI. Improvements in access to timely care for patients with STEMI will require a multifaceted approach involving patient education, improvements in the Emergency Medical Services and emergency department components of care, the establishment of networks of STEMI-referral hospitals (not PCI capable) and STEMI-receiving hospitals (PCI capable), as well as coordinated advocacy efforts to work with payers and policy makers to implement a much-needed health care system redesign. By focusing now on system efforts for improvements in timely care for STEMI, we will complete the cycle of research initiated by Reimer and Jennings 30 years ago. Time is muscle... we must translate that into practice.