The main goal is to improve access to timely and effective primary PCI in all the European countries, through implementation programmes tailored to each specific national healthcare organisation.
In this framework, a symposium will be held in Istanbul, during Acute Cardiac Care 2012, dealing with several important aspects of STEMI treatment.
The organisation of STEMI systems of care, based on networks among cardiological institutions of different technological level, is the cornerstone of the modern treatment of STEMI, and has the aim to offer an equitable access to the best standard of care to all the STEMI patients.
Over the years, a clear reduction in STEMI mortality has been shown in clinical registries in many countries. This goal has been achieved through the implementation of fast transportation to PCI-capable hospitals, the use of pre-hospital fibrinolysis and the integration of pharmaco-invasive strategies.
The Emergency Medical System of a big city should allow a faster and safer transportation from the STEMI place to the nearest PCI-capable hospital with a programme of 24 hours/7 days primary PCI. The resolution of the ST elevation in the ECG is a proxy not only of epicardial coronary artery reopening but also of normal blood flow at microvascular level. It should be carefully monitored, to have hints on the coronary situation of the patient, for risk stratification and to programme further actions in case of need.
STEMI can happen at any time of the day and of the night and the need of the fastest possible treatment causes many organisational problems to the primary PCI centres, which has to offer an experienced service on a 24 hours/7 days basis. The development of better organisation and improved standard of care made possible to have the same clinical results of the primary PCI treatment during both the "on" and the "off" hours of the day.
ACCA Past President (2006-2008)