International Circulation: Thank you Dr. Suryapranata for joining us today. I’d like to ask you a few questions today about treating STEMI patients， but first address you talk today speaking about the best reperfusion strategy for the greatest number of patients， a slight different viewpoint from the more often discussed individualized treatment. Can you briefly define some of the characteristics of the “greatest number of patients” as you discussed in your presentation?
Dr. Harry Suryapranata: If you talk about reperfusion therapy I think it is necessary to go back to what it was that caused it. One of the latest breakthroughs in interventional cardiology was back in 1993 when the treatment of acute myocardial infarction (MI) patients changed away from medical therapy. If you look at the mortality rate， lets say in my country， the Netherlands， which is a small country of 60 million inhabitants， in the 1950s the mortality rate was approximately 25%. It later went down dramatically to less than 10%， particularly after the introduction of thrombolytic therapy， one of the reperfusion therapies， and subsequently primary PCI， which is what we are talking about today. It took 10 years after that was first published before these treatments were recommended in guidelines. The problem now is not how to do it. PCI， or coronary intervention， for acute MI can be done by everyone who is skillful in conducting PCI. The key point is organization. How do we bring the greatest number of those patients early enough to undergo that treatment and achieve these positive outcomes. The key point is organization.
There have been three key achievements since the breakthrough in 1993. One is the development of PCI techniques over the past decades. Second is the adjunctive drug therapy. There is currently drug therapy available to us such as an extensive anti-thrombotic arsenal to treat before and after the coronary intervention. Finally， the better organization of CATH which has resulted in an improvement in assessment to PCI centers.
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