Effective Reperfusion for Acute Myocardial Infarction Begins with Effective Health Policy
Authors: Thomas H. Lee
Journal: Annals of Internal Medicine (1997)

Editorials15 April 1997Effective Reperfusion for Acute Myocardial Infarction Begins with Effective Health PolicyThomas H. Lee, MDThomas H. Lee, MDPartners Community HealthCare, Inc., Boston, MA 02199Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-8-199704150-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail "Time is muscle" is a cute but concise summary of two decades of research demonstrating the value of reperfusion therapy for patients with acute myocardial infarction and the importance of early initiation of treatment. On the basis of this research, the National Heart, Lung, and Blood Institute launched the National Heart Attack Alert Program in 1991. This program promotes the goal of treating acute myocardial infarction within 60 minutes of the onset of symptoms [1] and has helped many hospitals reduce the time between presentation and the initiation of thrombolytic therapy to less than 30 minutes. No evidence, however, suggests ...References1. National Heart Attack Alert Program Coordinating Committee 60 Minutes to Treatment Working Group. Emergency Department: Rapid Identification and Treatment of Patients with Acute Myocardial Infarction. Bethesda, MD: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Heart, Lung, and Blood Institute; 1993. NIH publication no. 93-3278. Google Scholar2. Gurwitz JH, McLaughlin TJ, Willison DJ, Guadagnoli E, Hauptman PJ, Gao X, et al. Delayed hospital presentation in patients who have had acute myocardial infarction. Ann Intern Med. 1997; 126:593-9. Google Scholar3. Yarzebski J, Goldberg RJ, Gore JM, Alpert JS. Temporal trends and factors associated with extent of delay to hospital arrival in patients with acute myocardial infarction: the Worcester Heart Attack Study. Am Heart J. 1994; 128:255-63. Google Scholar4. Dracup K, Moser DK, Eisenberg M, Meischke H, Alonzo AA, Braslow A. Causes of delay in seeking treatment for heart attack symptoms. Soc Sci Med. 1995; 40:379-92. Google Scholar5. Gaspoz JM, Unger PE, Urban P, Chevrolet JC, Rutishauser W, Giacobino H, et al. Delay in management and treatment of patients with suspected acute myocardial infarction: role of the public, of extra- and intrahospital structures and transportation methods. Schweiz Med Wochenschr. 1993; 123:1376-83. Google Scholar6. Moses HW, Engelking N, Taylor GJ, Prabhakar C, Vallala M, Colliver JA, et al. Effect of a two-year public education campaign on reducing response time of patients with symptoms of acute myocardial infarction. Am J Cardiol. 1991; 68:249-51. Google Scholar7. Ho MT, Eisenberg MS, Litwin PE, Schaeffer SM, Damon SK. Delay between onset of chest pain and seeking medical care: the effect of public education. Ann Emerg Med. 1989; 18:727-31. Google Scholar8. Herlitz J, Hartford M, Blohm M, Karlson BW, Ekstrom L, Risenfors M, et al. Effect of a media campaign on delay times and ambulance use in suspected acute myocardial infarction. Am J Cardiol. 1989; 64:90-3. Google Scholar9. Mitic WR, Perkins J. The effect of a media campaign on heart attack delay and decision times. Can J Public Health. 1984; 75:415-8. Google Scholar10. Kerr HD. Access to emergency departments: a survey of HMO policies. Ann Emerg Med. 1989; 18:274-7. Google Scholar11. Hamburg RS, Ballin SD. Congress moves to address emergency cardiac care issues [News]. Circulation. 1995; 92:149-51. Google Scholar12. Burnett RE, Blumenthal JA, Mark DB, Leimberger JD, Califf RM. Distinguishing between early and late responders to symptoms of acute myocardial infarction. Am J Cardiol. 1995; 75:1019-22. Google Scholar13. Ell K, Haywood LJ, deGuzman M, Sobel E, Norris S, Blumfield D, et al. Differential perceptions, behaviors, and motivations among African Americans, Latinos, and whites suspected of heart attacks in two hospital populations. J Assoc Acad Minor Phys. 1995; 6:60-9. Google Scholar Author, Article, and Disclosure InformationAuthors: Thomas H. Lee, MDAffiliations: Partners Community HealthCare, Inc., Boston, MA 02199Corresponding Author: Thomas H. Lee, MD, Partners Community HealthCare, Inc., Suite 1150, Prudential Tower, 800 Boylston Street, Boston, MA 02199.Corresponding Author: Thomas H. Lee, MD, Partners Community HealthCare, Inc., Suite 1150, Prudential Tower, 800 Boylston Street, Boston, MA 02199. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDelayed Hospital Presentation in Patients Who Have Had Acute Myocardial Infarction Jerry H. Gurwitz , Thomas J. McLaughlin , Donald J. Willison , Edward Guadagnoli , Paul J. Hauptman , Xiaoming Gao , and Stephen B. Soumerai Metrics Cited by"Time is brain" also for bacterial meningitisTeam-based model for non-operating room airway management: validation using a simulation-based studyThe effect of health care provider consultation on acute coronary syndrome care-seeking delayTime Is Brain—QuantifiedThe construction of a modern epidemic: the implications for women of the gendering of coronary heart diseaseDelay times and management of acute myocardial infarction in Indigenous and non‐Indigenous people in the Northern TerritoryMissed opportunities to impact fast response to AMI symptomsBeyond Administrative Data: Characterizing Cardiorespiratory Disease Episodes Among Patients Visiting the Emergency DepartmentEmerging concepts in the management of acute myocardial infarction in patients with diabetes mellitusDelayed Thrombolytic Treatment of Older Patients with Acute Myocardial Infarction 15 April 1997Volume 126, Issue 8Page: 652-653KeywordsAcute myocardial infarctionHealth insuranceHeart failureMedical educationMusclesMyocardial infarctionPatientsPrimary care physiciansReperfusionSigns and symptoms ePublished: 15 August 2000 Issue Published: 15 April 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. 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