Stemi Interventions: Commentary

Sameer Mehta, MD, FACC, MBA, is studying ST-elevation myocardial infarction interventions in his work with short door-to-balloon time primary PCI and the Single INdividual Community Experience REgistry for Primary PCI (SINCERE) database at 5 community hospitals in Miami, Florida, now over 365 patients. A past chief of interventional cardiology and director of the cardiovascular laboratory at Cedars Medical Center in Miami, as well as former President of the American Heart Association (Miami Dade Division), Dr. Mehta is a Voluntary Associate Clinical Professor of Medicine at the University of Miami-School of Medicine. Dr. Mehta is also president of the Indo-American Society of Interventional Cardiologists (ISIC) and a course director for LUMEN 2009: The Symposium on Optimal Treatments for Acute MI (www.lumenAMI.com). He has recently published the Textbook of STEMI Interventions (available through HMP Communications at https://www. stemiinterventions.com). Dr. Mehta will be commenting on the important work going on around the world as societies and their hospitals struggle to educate patients about the importance of timely intervention in ST-elevation myocardial infarction, and work collaboratively to decrease the time from patient arrival to intervention. This issue of Cath Lab Digest brings another successful door-to-balloon (D2B) ST-elevation myocardial infarction (STEMI) initiative, “Code 42: A Quality Initiative Program for Improving Door-to-Balloon Times in ST-Elevation Myocardial Infarctions,” submitted by Katherine P. Kelly, RN, from Resurrection Medical Center in Chicago, Illinois. In a well-compiled manuscript, laced with pertinent references, Ms. Kelly has enumerated pragmatic translations of the now-famous work from the Yale investigators1, wherein Bradley and colleagues outlined six outstanding strategies to lower D2B times for STEMI interventions. The Code 42 initiative is comprised of a broad, interdisciplinary committee that used the Bradley strategies, modified to suit the specific needs of Resurrection Medical Center. In this manner, they created a living document that could be readily applied to save countless lives. The methodology created by the Code 42 committee won broad support from the critical constituency represented by the administration, emergency department (ED) and cardiovascular laboratory (CVL). Herein exists the vital ingredient that led to the success at Resurrection — teamwork. With teamwork, broad consensus, quality assurance, data management and peer review, Resurrection Medical Center can now boast of an outstanding STEMI program, for which we extend them our felicitations. Using the Resurrection Medical Center experience as a model, I would like to offer the following three additional observations: 1. In presenting this outstanding work, Ms. Kelley presents excellent data about the reduction in D2B times at her institution. Door-to-balloon times of Dr. Mehta can be contacted at mehtas@bellsouth.net

1. Bradley EH, Herrin J, Wang Y, Barton BA, Webster TR, Mattera JA, et al. Strategies for reducing the door-to-balloon time in acute myocardial infarction. N Engl J Med 2006; 355:2308-2320.
2. Mehta S, ed. Textbook of STEMI Interventions. Malvern, PA: HMP Communications; 2008.