2013 consensus statement for early reperfusion and pharmaco-invasive approach in patients presenting with chest pain diagnosed as STEMI (ST elevation myocardial infarction) in an Indian setting.

摘要: In India, the prevalence of ST elevation myocardial infarction (STEMI) is rising exponentially leading to cardiovascular morbidity and mortality. Despite advancement in reperfusion therapy (pharmacologic interventional), overall utilization, system care timely remains suboptimal. JUSTIFICATION AND PURPOSE: Alarming treatment delays exist patients presenting with chest pain observed real-world published evidences. Time diagnose STEMI initiation at various first medical contacts India variable mandating immediate attention. We intend provide evidence based explicit recommendations for practicing clinicians about time-dependent early management concept pharmaco-invasive (PI) approach, contextualized situation India. Process Pre-prepared guidance document by expert steering committee was discussed commented over 150 experts representing from 16 states regional level. The moderators these meetings arrived a consensus on evaluation PI approach improve clinical outcomes. Recommendations addition patient awareness education symptom identification, required general practitioners physicians/intensivists implement time dependent management. Percutaneous Coronary Intervention (PCI) gold standard, yet it inaccessible majority patients, hence initial use fibrinolytics recommended followed coronary intervention. Fibrinolytics are easily available, economical evaluated several studies we recommend (early fibrinolysis PCI 3-24 hours later). guided 'Protocol/Plan Action' implementing level practitioners, non-PCI hospitals/nursing homes intensive facility capable centers. For duration