International Circulation: The AHA guideline emphasized that primary PCI for STEMI should be performed by a “qualified” cardiovascular interventionalist. However， in China experienced physicians and big clinical centers are all located in large urban areas and it is very difficult to transfer STEMI patients from suburban areas to qualified centers. So， do you have any suggestion in solving this problem that you can share with your Chinese counterparts?
　　Prof. King: I am aware of how some of these cases are dealt with in China. Sometimes the feeling is that it is easier to move the physician than the patient and so physicians and teams have been moved to an area that has a catheter lab facility with equipment for primary angioplasty for STEMI patients but the personnel to do it are not onsite. I do not know how long this will continue to be a problem in China but this method has been applied by some in an attempt to manage the problem. Inevitably， there will be some patients who can not get to a facility to have a primary angioplasty and so we must remember that thrombolytic therapy in many cases is life saving and should not be avoided if PCI is not available and it is an appropriate patient for thrombolytic therapy.

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