1. In search of lost time: modern treatment of acute myocardial infarction. Paweł Buszman, MD, FESC, FACC Upper Silesian Heart Center Katowice, Poland Snowmass, Co 15.03.2007

2. ESC: STEMI/PCI Guidlines

3. 24h/7d cath labs for AMI treatment: 20 year experience! Population of Upper-Silesia: 4,9 mln 50 km KATOWICE: GCM, SLAM Zabrze AHP: Cath labs 1 mln. Bielsko Ustroń Dąbrowa G. Transportation: Max. 30 min. to the nearest cath lab Częstochowa Rybnik

4. American Heart of Poland, Ltd www.klinikiserca.pl Suspicion of ACS-ECG in ambulance Transmission of ECG from ambulance to cath lab in a reference center acceptation by interventional cardiologist Reference center with cah lab Local hospital STEMI or High Risk ACS ECG transmission through mobile phone LIFE NET SYSTEM (MEDTRONIC) Low risk ACS or non-coronary chest pain

5. American Heart of Poland, Ltd www.klinikiserca.pl

6. American Heart of Poland, Ltd www.klinikiserca.pl

7. American Heart of Poland, Ltd www.klinikiserca.pl Prox. LAD occlusion Stent implantation After stenting

8. American Heart of Poland, Ltd www.klinikiserca.pl

9. American Heart of Poland, Ltd www.klinikiserca.pl

10. In-hospital mortality vs treatment modality Silesian Registry of ACS October 2003 – September 2004 (12 month) 8,4%1,4%11,3%

11. 30-day mortality 10,1%2,2%13,0% Silesian Registry of ACS October 2003 – September 2004 (12 miesięcy)

12. Treatment strategy – Time – Prognosis Time: Chest pain – hospital admission 30 day mortality Silesian Registry of ACS October 2003 – September 2004 (12 miesięcy)