Primary angioplasty for ST-segment elevation myocardial infarction: Ready for prime time?

The treatment of ST-segment elevation myocardial infarction has undergone profound changes since the bedrest era of the 1960s. Most recently, the use of percutaneous coronary intervention (PCI) has been,shown to be superior to thrombolysis. However, to be effective, PCI must be done as soon as possible after MI. Patients in large urban areas of Canada may have access to PCI, but what about those in most other areas? We asked 2 groups of authors to Comment on the gap between evidenced and implementation as well as the barriers to round-the-clock PCI capability in Canada and how they can be overcome. The perspective of William Ghali and coauthors follows this comment.