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[Correspondence] Consequence of reimbursement policy alteration for urgent PCI in Japan

Establishing timely coronary revascularisation (eg, percutaneous coronary intervention [PCI]) in acute coronary syndrome has become a distinctive performance measure worldwide. Clinical guidelines recommend a door-to-balloon time of 90 min or less for patients with ST-elevation myocardial infarction (STEMI).1 In light of these guideline recommendations, the Japanese Ministry of Health, Labour and Welfare introduced a new reimbursement policy in April, 2014, providing an additional hospital incentive of approximately US$3500 when patients with positive cardiac biomarkers (eg, troponins) achieved a door-to-balloon time of 90 min or less.