Changing times in the treatment of myocardial infarction

Infarct angioplasty has the potential to increase the disparity in outcomes between rural and urban patients with myocardial infarction

The need for rapid treatment of coronary syndromes has been recognised for many years. Despite recent emphasis on the benefits of rapid thrombolysis, the main advantage of early presentation remains resuscitation from ventricular fibrillation. Defibrillation has been estimated to save about six times as many lives as thrombolytic treatment,1 but patients must reach medical assistance in time for it to be effective.