Access to Percutaneous Coronary Intervention Facilities and Clinical Outcomes in Patients With Acute Myocardial Infarction

By
Yu-Chu Shen
Renee Y. Hsia
October 12, 2026

Jama Network Open

Overview

The study evaluated whether newly opened percutaneous coronary intervention (PCI) facilities were associated with access, PCI use, and outcomes among California residents with acute myocardial infarction (AMI) from 2011 through 2022. The supplied article excerpt describes the study rationale and methods but does not provide its results, so the direction or magnitude of any association cannot be reported.

Background

Prompt PCI is an established treatment for AMI, and the source states that timely delivery is associated with improved survival and fewer complications. The expansion of PCI facilities may reduce geographic barriers, but additional centers in areas already served could disperse procedural volume and expertise; earlier studies cited in the article associated higher PCI volume with lower mortality. The study therefore examined facility openings in communities with and without baseline PCI access. It included both STEMI and NSTEMI, noting that early invasive management is recommended for selected patients with NSTEMI.

Data Highlights

Study element	Details reported in the supplied excerpt
Population and period	California residents with a primary AMI diagnosis, January 1, 2011, through December 31, 2022
AMI groups	STEMI and NSTEMI
Data sources	California HCAI Patient Discharge Data, Emergency Department Data, and Ambulatory Surgery Data; annual facility utilization files
Geographic access measure	Whether a community zip-code centroid was within a 30-minute drive of a PCI-capable facility, using routine-traffic drive times
Outcomes and results	The excerpt describes evaluation of access, PCI use, and clinical outcomes but supplies no numerical results or effect estimates

Key Findings

The study assessed the association between newly opened PCI facilities and outcomes among California patients with AMI over 2011–2022.
Communities were classified by baseline access to PCI facilities, with geographic access defined as being within a 30-minute drive of a PCI-capable hospital.
The analysis included both STEMI and NSTEMI cases; the article notes that early invasive management applies to selected patients with NSTEMI.
Patient-level data were drawn from three California HCAI sources covering inpatient and outpatient encounters, with identifiers enabling longitudinal linkage and mortality assessment.
Facility data included PCI volumes, ownership, facility characteristics, and hospital geographic coordinates.
The supplied excerpt contains no study results, numerical estimates, or conclusions about whether facility openings changed PCI use, access, or survival.

Clinical Implications

The excerpt establishes that geographic access and baseline availability of PCI facilities were central to the study design, but it does not report findings that support a clinical or health-system recommendation. The 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline states that primary PCI for STEMI should be delivered as soon as possible, with first-device activation within 90 minutes of first medical contact for walk-in or EMS-transported patients and within 120 minutes for transfers from non-PCI-capable facilities.

Conclusion

The article addresses whether PCI facility expansion is associated with access and outcomes in communities with differing baseline access. Because the supplied study excerpt omits its results, no conclusion about the effects of new facilities can be drawn from the provided material.