We know primary PCI is a race against time both for the patient and his physician.
What is the upper limit for this unique race where the stakes are high and it involves human lives and big corporate warfares ?
- 6 hours
- 12 hours
- 24 hours
- 36 hours
- 54 hours
- Time does not matter . You can do a PCI as late as possible as long as patient has sufficient insurance coverage and we have the expertise
Answer : 2
Please note there is only one exception . Cardiogenic shock has been given a extended lease of time window (Which can be technically up to 54 hours ) . PCI can be performed if the onset of shock is within 36 hours of STEMI and to be performed within 18 hours after the onset ! )* Even though we have a well set criteria for re-perfusion which bans primary PCI to be performed after 12 hours , cardiologists have enough technicalities to overcome this hurdle and keep doing the futile pPCI well after 12hours.
How they are able to indulge in these futilities without any ethical issue ?
The answer is very simple. Instead of calling it as primary PCI they refer to it as delayed PCI or rescue PCI ! Strict time specific guidelines are only for primary PCI . By changing the terminologies they make a mockery of the concept of time window which is vital for any intervention for STEMI !
Dr.S.Venkatesan MD 
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