PubMed · 7352795
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R L Coskey. 1980. Intermediate coronary care.. https://pubmed.ncbi.nlm.nih.gov/7352795/
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In centers without hemodynamic laboratories the quality of medical care may be suboptimal since the unavailability of these technologies may reduce medical experience in the treatment of heart disease, mostly in acute coronary syndromes, and may increase the need for referring some patients to other hospitals. The problem will be of great relevance in the case of expansion of the aggressive approach in the treatment of acute ischemic syndromes such as acute myocardial infarction and unstable angina. The impelling need for small centers of improving medical care may promote the spontaneous and uncontrolled proliferation of hemodynamic laboratories. The high number of hemodynamic laboratories may lead to a low institutional volume and, as a consequence, may negatively influence the outcome of coronary intervention and increase health care costs. The experience of operators and the costs are probably more relevant as regards angioplasty than coronary angiography. Therefore we propose the implementation of departments of interventional hemodynamic laboratories including different hospitals: diagnostic laboratories will be allocated in hospitals with coronary care units, while interventional laboratories will be allocated in referring hospitals.
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Ischemic heart disease is the most common cause of death in the western world. Acute myocardial infarction is one of the most life-threatening manifestations of ischemic heart disease. Treatment of acute myocardial infarction has dramatically improved over the past 100 years by the introduction of coronary care units, mobile coronary care units, improved treatment of cardiac arrest plus the introduction of beta-blockers, fibrinolytic agents, aspirin, ACE-inhibitors and lipid lowering drugs. This has resulted in a marked reduction of mortality.