Guidelines for Percutaneous Coronary Interventions

The European Society of Cardiology (ESC, Sophia Antipolis, France) has released its Guidelines on Percutaneous Coronary Interventions (PCI).

According to these guidelines, PCI can be regarded as the first option for a larger group of patients with acute coronary syndromes than before, since recent improvements have made PCI a procedure that can be safely and effectively applied to patients with various types of coronary lesions and patients with and without myocardial infarction. The new guidelines represent the consensus of a Task Force of European experts, chaired by Professor Sigmund Silbur of the Gemeinschaftspraxis Hospital (Munich, Germany).

One highlight of the guidelines is that thrombolysis for a heart attack can be administered within the first three hours after onset of chest pain, if no catheter lab is accessible, preferably within 90 minutes. Thrombolysis should be followed by invasive diagnosis and treatment, if applicable.

Because of differences in infrastructure between Europe and the United States, the guidelines differ from U.S. guidelines when addressing issues of time and distance to catheter laboratories. European guidelines are based on the likelihood that most patients can reach a catheter lab within 90 minutes after first medical contact. Also, the ESC guidelines do not demand on-cite cardiac surgery for PCI, since so many more hospitals are in a position to offer high-quality PCI.

"The field of PCI is constantly and rapidly evolving,” explained Professor Silber. "We are always waiting for the next study and development. Following each new study, we need to re-evaluate our thinking and clinical practice.” The guidelines are available on the ESC website (www.escardio.org).




Related Links:
European Society of Cardiology