In this issue of THE JOURNAL, McGrath and colleagues1
and Magid and colleagues2 examine 2 of the
most contentious issues in the provision of cardiac care: the relationship
between experience and outcome for percutaneous interventions, and the superiority
of percutaneous revascularization (eg, primary angioplasty or other procedures)
relative to thrombolytic therapy for acute myocardial infarction (AMI). These
2 issues lead to the question of whether primary angioplasty can be effectively
performed in low-volume hospitals and by low-volume physicians. Supporters
of both primary angioplasty and volume standards will no doubt refer to these
works in their future deliberations.
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