Same-day discharge (SDD) following elective percutaneous coronary intervention (PCI) has gained popularity; however, uptake varies worldwide, and existing SDD consensus documents have largely been developed without input from clinicians and consumers. We aimed to develop an SDD clinical pathway in collaboration with clinicians, patients, and carers.
Method
This was a mixed-methods study. The AGREE II instrument was used to guide the development of the SDD clinical pathway to ensure rigour. A hybrid workshop, allowing both online and in-person attendance, was conducted with participants from six public hospitals in Queensland, Australia. The project funded all participants’ travel to the workshop to maximise in-person attendance. A modified seven-step nominal group technique was used to guide the workshop and refine the clinical pathway. Sessions in Step 4 (participants presented ideas one by one) and Step 5 (researchers provided clarification) were audio-recorded and transcribed verbatim. Deductive content analysis was undertaken. We counted and recorded numbers for quantitative data.
Results
A total of 15 participants took part in the study, including nurses (n=6), medical officers (n=5), patients (n=3), and a carer representative (n=1). Consensus was achieved for six out of seven pre-PCI factors, all 14 post-PCI factors, all nine pre-discharge checklist statements, and all five risk management statements. All participants agreed that, despite the consensus, the final SDD decision should remain with the interventional cardiologist performing the procedure.
Conclusions
Our approach has demonstrated that the developed clinical pathway is not only evidence-based but also considers contextual factors and the needs of consumers. It will assist clinicians in making decisions about SDD in hospitals, thereby enhancing the efficiency of cardiac service delivery and improving patient satisfaction.
{"title":"Developing a Same-Day Discharge Clinical Pathway for Patients Undergoing Elective Percutaneous Coronary Intervention Using a Nominal Group Technique","authors":"Yingyan Chen PhD , Jacqueline Peet PhD , Natalie Hausin MSc , David Hinds GradDipNurs(CritCare) , Rohan Jayasinghe MBBS , Wendy Kennedy MSc , Suzanne Morris MSc , Rohan Poulter MBBS , Gregory Starmer MBBS , Yash Singbal MBBS , Anna Townsend MSc , Paul Wallis GradCertNurs(CritCare) , Raibhan Yadav FRACP , Zhihua Zhang MBBS , Karen Wardrop CertNursing , Junel Padigos PhD , Frances Fengzhi Lin PhD","doi":"10.1016/j.hlc.2025.07.006","DOIUrl":"10.1016/j.hlc.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Same-day discharge (SDD) following elective percutaneous coronary intervention (PCI) has gained popularity; however, uptake varies worldwide, and existing SDD consensus documents have largely been developed without input from clinicians and consumers. We aimed to develop an SDD clinical pathway in collaboration with clinicians, patients, and carers.</div></div><div><h3>Method</h3><div>This was a mixed-methods study. The AGREE II instrument was used to guide the development of the SDD clinical pathway to ensure rigour. A hybrid workshop, allowing both online and in-person attendance, was conducted with participants from six public hospitals in Queensland, Australia. The project funded all participants’ travel to the workshop to maximise in-person attendance. A modified seven-step nominal group technique was used to guide the workshop and refine the clinical pathway. Sessions in Step 4 (participants presented ideas one by one) and Step 5 (researchers provided clarification) were audio-recorded and transcribed verbatim. Deductive content analysis was undertaken. We counted and recorded numbers for quantitative data.</div></div><div><h3>Results</h3><div>A total of 15 participants took part in the study, including nurses (n=6), medical officers (n=5), patients (n=3), and a carer representative (n=1). Consensus was achieved for six out of seven pre-PCI factors, all 14 post-PCI factors, all nine pre-discharge checklist statements, and all five risk management statements. All participants agreed that, despite the consensus, the final SDD decision should remain with the interventional cardiologist performing the procedure.</div></div><div><h3>Conclusions</h3><div>Our approach has demonstrated that the developed clinical pathway is not only evidence-based but also considers contextual factors and the needs of consumers. It will assist clinicians in making decisions about SDD in hospitals, thereby enhancing the efficiency of cardiac service delivery and improving patient satisfaction.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Pages 116-126"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.hlc.2025.07.017
Maria Giulia Bellicini MD
{"title":"What is HFpEF? Why it may not be Real Heart Failure","authors":"Maria Giulia Bellicini MD","doi":"10.1016/j.hlc.2025.07.017","DOIUrl":"10.1016/j.hlc.2025.07.017","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Page e3"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/S1443-9506(25)01788-3
{"title":"Cardiac Society of Australia and New Zealand","authors":"","doi":"10.1016/S1443-9506(25)01788-3","DOIUrl":"10.1016/S1443-9506(25)01788-3","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Page 149"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hlc.2025.07.004
Rut Andrea MD, PhD , Marc Izquierdo-Ribas MD , Esther Sanz MD , Cosme García-García MD, PhD , Antonia Sambola MD, PhD , Alessandro Sionis MD, PhD , José Carlos Sánchez-Salado MD, PhD , Pablo Pastor MD , Youcef Azeli MD, PhD , Gil Bonet Pineda MD , Maria José Martínez-Membrive MD , Toni Soriano-Colomé MD , Jordi Sans-Roselló MD, PhD , Eva Moreno-Monterde MD , Carlos Roca-Guerrero MD , José Ortiz-Pérez MD, PhD , Teresa López-Sobrino MD , Oriol de Diego MD, PhD , Xavier Freixa MD, PhD , Pablo Loma-Osorio MD, PhD
Background
Out-of-hospital cardiac arrest (OHCA) remains a leading cause of cardiovascular mortality, yet significant gaps persist in understanding how contemporary management strategies influence long-term outcomes.
Aim
We sought to provide novel insights into the characteristics, management variability, and 6-month outcomes of patients with OHCA admitted to eight intensive cardiovascular care units during a contemporary period.
Method
This was a prospective multicentre registry of patients with OHCA admitted to intensive cardiovascular care units from October 2020 to December 2021. Patients were categorised by prognosis as either favourable outcome (Cerebral Performance Category [CPC] 1–2) or non-favourable outcome, including death (CPC 3–5). A multinomial logistic regression identified independent predictors of CPC 3–5.
Results
Among 288 patients, only 17.36% were women. Most arrests (88.93%) were witnessed, yet bystander cardiopulmonary resuscitation was initiated in just 69.18% of cases. Despite 80% of patients presenting with a shockable rhythm, an automated external defibrillator was used in only 58%. Median time to return of spontaneous circulation (ROSC) was 28 minutes. Marked variability in post-resuscitation care was observed across centres in the use of targeted temperature management, emergent coronary angiography, and multimodal neuroprognostication. At 6 months, 49% of patients exhibited CPC 1–2. Ninety-three per cent of discharged patients maintained a favourable neurological outcome, and 15% improved their CPC score. Independent predictors of CPC 3-5 included older age (p=0.005), male sex (p=0.016), previous stroke (p=0.046), prolonged time to ROSC (p<0.001), and a non-shockable initial rhythm (p<0.001). Hypoxic-ischaemic brain injury was the leading cause of in-hospital death (72.90%).
Conclusions
Nearly half of the patients with OHCA survived with a favourable neurological outcome, which persisted after 6 months. Despite significant in-hospital interventions, pre-hospital factors remained the strongest predictors of neurological outcome. The high degree of management variability suggests an urgent need for standardised protocols and supports the creation of cardiac arrest centres.
{"title":"Evolution and Contemporary Predictors of Outcomes in Out-of-Hospital Cardiac Arrest Patients Admitted to Intensive Cardiovascular Care Units: The Multicentric PCR-Cat Registry","authors":"Rut Andrea MD, PhD , Marc Izquierdo-Ribas MD , Esther Sanz MD , Cosme García-García MD, PhD , Antonia Sambola MD, PhD , Alessandro Sionis MD, PhD , José Carlos Sánchez-Salado MD, PhD , Pablo Pastor MD , Youcef Azeli MD, PhD , Gil Bonet Pineda MD , Maria José Martínez-Membrive MD , Toni Soriano-Colomé MD , Jordi Sans-Roselló MD, PhD , Eva Moreno-Monterde MD , Carlos Roca-Guerrero MD , José Ortiz-Pérez MD, PhD , Teresa López-Sobrino MD , Oriol de Diego MD, PhD , Xavier Freixa MD, PhD , Pablo Loma-Osorio MD, PhD","doi":"10.1016/j.hlc.2025.07.004","DOIUrl":"10.1016/j.hlc.2025.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) remains a leading cause of cardiovascular mortality, yet significant gaps persist in understanding how contemporary management strategies influence long-term outcomes.</div></div><div><h3>Aim</h3><div>We sought to provide novel insights into the characteristics, management variability, and 6-month outcomes of patients with OHCA admitted to eight intensive cardiovascular care units during a contemporary period.</div></div><div><h3>Method</h3><div>This was a prospective multicentre registry of patients with OHCA admitted to intensive cardiovascular care units from October 2020 to December 2021. Patients were categorised by prognosis as either favourable outcome (Cerebral Performance Category [CPC] 1–2) or non-favourable outcome, including death (CPC 3–5). A multinomial logistic regression identified independent predictors of CPC 3–5.</div></div><div><h3>Results</h3><div>Among 288 patients, only 17.36% were women. Most arrests (88.93%) were witnessed, yet bystander cardiopulmonary resuscitation was initiated in just 69.18% of cases. Despite 80% of patients presenting with a shockable rhythm, an automated external defibrillator was used in only 58%. Median time to return of spontaneous circulation (ROSC) was 28 minutes. Marked variability in post-resuscitation care was observed across centres in the use of targeted temperature management, emergent coronary angiography, and multimodal neuroprognostication. At 6 months, 49% of patients exhibited CPC 1–2. Ninety-three per cent of discharged patients maintained a favourable neurological outcome, and 15% improved their CPC score. Independent predictors of CPC 3-5 included older age (p=0.005), male sex (p=0.016), previous stroke (p=0.046), prolonged time to ROSC (p<0.001), and a non-shockable initial rhythm (p<0.001). Hypoxic-ischaemic brain injury was the leading cause of in-hospital death (72.90%).</div></div><div><h3>Conclusions</h3><div>Nearly half of the patients with OHCA survived with a favourable neurological outcome, which persisted after 6 months. Despite significant in-hospital interventions, pre-hospital factors remained the strongest predictors of neurological outcome. The high degree of management variability suggests an urgent need for standardised protocols and supports the creation of cardiac arrest centres.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1389-1398"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hlc.2025.06.1022
Claudia R. Brick BMedSc, MBBS , Benjamin Cailes BMedSci, FRACP , Avik Majumdar MPHTM, PhD, FRACP , Adam Testro FRACP, PhD , Marie Sinclair BMedSci, FRACP, PhD , Ali Al-Fiadh FRACP, PhD , Laurence Weinberg MD, FANZCA, PhD , Jeyamani Ramachandran FRACP, PhD , Madeleine Gill FRACP , Omar Farouque FACC, PhD , Anoop N. Koshy FRACP, PhD
Cardiac comorbidities in patients with cirrhosis are common yet frequently under-recognised. Cirrhotic cardiomyopathy, a subclinical state of cardiac dysfunction, is emerging as a critical contributor to major adverse cardiac events in this patient population, as well as liver events such as hepatorenal syndrome. The increasing prevalence of patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease also poses significant management challenges for these patients. This review focuses on the considerable burden of cardiac disease in patients with cirrhosis, most notably in those undergoing assessment for liver transplantation. Our findings highlight the importance of early detection and the use of appropriate management strategies to enhance post-transplant cardiovascular outcomes.
{"title":"CardioHepatology: Exploring the Interplay Between Cirrhosis, Cirrhotic Cardiomyopathy, Coronary Artery Disease, and Liver Transplantation","authors":"Claudia R. Brick BMedSc, MBBS , Benjamin Cailes BMedSci, FRACP , Avik Majumdar MPHTM, PhD, FRACP , Adam Testro FRACP, PhD , Marie Sinclair BMedSci, FRACP, PhD , Ali Al-Fiadh FRACP, PhD , Laurence Weinberg MD, FANZCA, PhD , Jeyamani Ramachandran FRACP, PhD , Madeleine Gill FRACP , Omar Farouque FACC, PhD , Anoop N. Koshy FRACP, PhD","doi":"10.1016/j.hlc.2025.06.1022","DOIUrl":"10.1016/j.hlc.2025.06.1022","url":null,"abstract":"<div><div>Cardiac comorbidities in patients with cirrhosis are common yet frequently under-recognised. Cirrhotic cardiomyopathy, a subclinical state of cardiac dysfunction, is emerging as a critical contributor to major adverse cardiac events in this patient population, as well as liver events such as hepatorenal syndrome. The increasing prevalence of patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease also poses significant management challenges for these patients. This review focuses on the considerable burden of cardiac disease in patients with cirrhosis, most notably in those undergoing assessment for liver transplantation. Our findings highlight the importance of early detection and the use of appropriate management strategies to enhance post-transplant cardiovascular outcomes.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1362-1372"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hlc.2025.05.087
Mugdha A. Joshi MD , Venkat S. Manubolu MD, MPH , April Kinninger MPH , Rui Wang MS , Robyn L. McClelland PhD , Sion K. Roy MD , Matthew J. Budoff MD
Background
Studies have linked aortic calcification to an increased risk of all-cause mortality and cardiovascular mortality. There is minimal evidence evaluating the sex differences in the prevalence of aortic arch calcification (AAC) in relation to zero coronary artery calcium (CAC).
Method
This study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) exam 5, of which 2,564 underwent non-contrast chest computed tomography scans. We utilised the CAC and AAC scores measured by the Agatston method to evaluate sex differences in AAC among participants overall, and among those with zero CAC. Regression analysis was performed, adjusting for covariates, to evaluate the sex difference.
Results
The average age of the 2,564 participants was 69.2±9.2 years, 46% were women, 38% were White, 13% were Chinese, 27% were Black, and 22% were Hispanic/Latino. A total of 813 (32%) had a CAC of zero. The prevalence of AAC was higher in women than men, both in the zero CAC population (87% vs 80%) and overall (92% vs 90%). The median AAC was additionally higher in women in the overall population (217 vs 212) and in the CAC zero population (60 vs 20). After controlling for covariates, the estimated average AAC was 0.51 times lower in men than women (95% confidence interval 0.36–0.72; p<0.001) in the CAC zero population.
Conclusions
This study demonstrated that the prevalence of aortic arch calcium is higher in women compared to men. In a subset of the population with zero CAC, the average amount of AAC is significantly higher in women. In the future, event analysis should be done to determine whether these sex differences in AAC may partially explain the sex differences in the prediction of atherosclerotic cardiovascular disease events.
背景：研究已将主动脉钙化与全因死亡率和心血管死亡率的风险增加联系起来。很少有证据评估主动脉弓钙化（AAC）患病率与冠状动脉零钙（CAC）之间的性别差异。方法：本研究包括来自动脉粥样硬化多民族研究（MESA）检查5的参与者，其中2564人接受了非对比胸部计算机断层扫描。我们使用Agatston方法测量的CAC和AAC分数来评估参与者之间总体和无CAC的AAC的性别差异。进行回归分析，调整协变量，以评估性别差异。结果：2564名参与者的平均年龄为69.2±9.2岁，46%为女性，38%为白人，13%为中国人，27%为黑人，22%为西班牙裔/拉丁裔。共有813例（32%）的CAC为零。无论是在无CAC人群（87% vs 80%）还是总体人群（92% vs 90%）中，女性的AAC患病率均高于男性。在总体人群中，女性的AAC中位数也更高（217 vs 212），而在CAC为零的人群中（60 vs 20）。在控制协变量后，估计男性的平均AAC比女性低0.51倍（95%置信区间0.36-0.72）。结论：本研究表明，女性主动脉弓钙的患病率高于男性。在没有CAC的人群中，女性的AAC平均含量明显更高。未来，应该进行事件分析，以确定AAC的这些性别差异是否可以部分解释预测动脉粥样硬化性心血管疾病事件的性别差异。
{"title":"Sex Differences in Aortic Arch Calcification With Zero Coronary Artery Calcium","authors":"Mugdha A. Joshi MD , Venkat S. Manubolu MD, MPH , April Kinninger MPH , Rui Wang MS , Robyn L. McClelland PhD , Sion K. Roy MD , Matthew J. Budoff MD","doi":"10.1016/j.hlc.2025.05.087","DOIUrl":"10.1016/j.hlc.2025.05.087","url":null,"abstract":"<div><h3>Background</h3><div>Studies have linked aortic calcification to an increased risk of all-cause mortality and cardiovascular mortality. There is minimal evidence evaluating the sex differences in the prevalence of aortic arch calcification (AAC) in relation to zero coronary artery calcium (CAC).</div></div><div><h3>Method</h3><div>This study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) exam 5, of which 2,564 underwent non-contrast chest computed tomography scans. We utilised the CAC and AAC scores measured by the Agatston method to evaluate sex differences in AAC among participants overall, and among those with zero CAC. Regression analysis was performed, adjusting for covariates, to evaluate the sex difference.</div></div><div><h3>Results</h3><div>The average age of the 2,564 participants was 69.2±9.2 years, 46% were women, 38% were White, 13% were Chinese, 27% were Black, and 22% were Hispanic/Latino. A total of 813 (32%) had a CAC of zero. The prevalence of AAC was higher in women than men, both in the zero CAC population (87% vs 80%) and overall (92% vs 90%). The median AAC was additionally higher in women in the overall population (217 vs 212) and in the CAC zero population (60 vs 20). After controlling for covariates, the estimated average AAC was 0.51 times lower in men than women (95% confidence interval 0.36–0.72; p<0.001) in the CAC zero population.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that the prevalence of aortic arch calcium is higher in women compared to men. In a subset of the population with zero CAC, the average amount of AAC is significantly higher in women. In the future, event analysis should be done to determine whether these sex differences in AAC may partially explain the sex differences in the prediction of atherosclerotic cardiovascular disease events.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1424-1429"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/S1443-9506(25)01731-7
{"title":"Cardiac Society of Australia and New Zealand","authors":"","doi":"10.1016/S1443-9506(25)01731-7","DOIUrl":"10.1016/S1443-9506(25)01731-7","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Page 1489"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hlc.2025.06.1035
Ryan Gadeley BMed , Ruth Arnold FRACP , David Amos FRACP , Stuart Moss FRACP , Alex Elder FRACP , Sameer Karve FRACP , Mark Adams FRACP, PhD , David Brieger FRACP PhD , Harry C. Lowe FRACP, PhD
Current European, American and Australasian guidelines recommend revascularisation for acute ST elevation myocardial infarction (STEMI) by immediate or “primary” percutaneous coronary intervention (pPCI), or if pPCI cannot be performed within 120 minutes, by thrombolysis followed by rescue PCI. This latter approach, despite its limitations, remains a cornerstone of STEMI care in rural and remote settings, where pPCI is not immediately available, and where one-third of the Australian population live.
This review evaluates the current status of thrombolysis and rescue PCI in rural and remote settings, examines the multiple changes that have occurred since its inception, and highlights persisting gaps in knowledge, to provide an up-to-date evaluation of this field, and an outlook for future directions, in this area of ongoing change.
{"title":"Rural and Remote Acute STEMI Diagnosis and Management: Current Status and Future Directions","authors":"Ryan Gadeley BMed , Ruth Arnold FRACP , David Amos FRACP , Stuart Moss FRACP , Alex Elder FRACP , Sameer Karve FRACP , Mark Adams FRACP, PhD , David Brieger FRACP PhD , Harry C. Lowe FRACP, PhD","doi":"10.1016/j.hlc.2025.06.1035","DOIUrl":"10.1016/j.hlc.2025.06.1035","url":null,"abstract":"<div><div>Current European, American and Australasian guidelines recommend revascularisation for acute ST elevation myocardial infarction (STEMI) by immediate or “primary” percutaneous coronary intervention (pPCI), or if pPCI cannot be performed within 120 minutes, by thrombolysis followed by rescue PCI. This latter approach, despite its limitations, remains a cornerstone of STEMI care in rural and remote settings, where pPCI is not immediately available, and where one-third of the Australian population live.</div><div>This review evaluates the current status of thrombolysis and rescue PCI in rural and remote settings, examines the multiple changes that have occurred since its inception, and highlights persisting gaps in knowledge, to provide an up-to-date evaluation of this field, and an outlook for future directions, in this area of ongoing change.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1332-1343"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号