Community Outreach in Terms of Early Heart Attack Care as a New Way of Thinking in Chest Pain Center/Unit Care Giving—Commentary on the German Chest Pain Unit Network

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Since publication of the comparison between the US and the German accreditation program by Breuckmann et al in 2015, the number of certified chest pain units (CPUs) in Germany so far raised to 256, and until June 2017, a total of 191 centers gained recertification.1,2 Until 2015, certification was based on the initial consensus document published in 2008.3 Hereafter, the German Cardiac Society published their first update of the consensus guidelines as the experiences collected during the first cycle of certifications, new guidelines, and the accompanying registry analyses required revision of the initial position paper.4,5 According to the update, existing CPUs should take advantage of innovations through a continuous evaluation and re-evaluation process.6 Current data from the unique German CPU registry confirm the efficacy of the concept providing a nationwide very high standard of care for chest pain patients by optimizing pre- and in-hospital care – a dynamic process, which is and remain constantly ongoing. In their recent article, Münzel et al7 rehighlighted some of the decisive criteria for successful certification, at the meantime giving some spotlights on data retrieved from the German CPU registry. In addition to the assortment of studies provided in their article, the registry also disclosed promising data on, for example, imaging within the CPU, off-hour care within the CPU, or risk stratification beside some critical analyses on potential improvements such as on the handling of troponin-negative acute coronary syndrome patients within the CPU.

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