Design and rationale of the North Indian ST‐Segment Elevation Myocardial Infarction Registry: A prospective cohort study

Abstract

ST‐segment elevation myocardial infarction (STEMI) is associated with increased mortality and morbidity. Although remarkable progress has been made in the management of STEMI in high‐income countries, contemporary data to evaluate processes and outcomes of STEMI care in India is limited. The North Indian ST‐segment elevation myocardial infarction (NORIN STEMI) registry is a prospective cohort study based at government funded and largely free of cost tertiary medical centers in New Delhi, India. These hospitals serve a large proportion of the patients with lower socioeconomic status presenting from multiple states in India, as many centers in these states lack adequate specialized cardiovascular care. The study has been approved by the Institutional Review Boards of each institution and informed consent has been obtained from study participants. The NORIN STEMI registry aims to provide important insights regarding contemporary risk factors profiles, practice patterns, and prognosis in patients with STEMI in an underserved population in North India. These findings may identify opportunities to improve the outcomes of patients with STEMI in India.

Missed Opportunities for Screening and Management of Dysglycemia among Patients Presenting with Acute Myocardial Infarction in North India: The Prospective NORIN STEMI Registry

“…Consistent with another registry-based study [ 10 ], NORIN STEMI participants were young, with a median age of 55 years. This observation adds to the increasing recognition of acute MI in the young worldwide [ 7 9 ] and is likely attributable to an increasing cardiometabolic risk factor burden at early stages of life [ 2 30 ]. In addition to dysglycemia, more than half of NORIN STEMI participants had an elevated BMI, highlighting the rapid increase in overweight and obesity in LMICs over the past three decades [ 14 31 ].…”

“…The aims and design of the prospective NORIN STEMI registry have been previously described [ 7 ]. Briefly, patients presenting with STEMI to two government-funded tertiary care medical centers in New Delhi, India were enrolled.…”

Prevalence and prognostic implications of reduced left ventricular ejection fraction among patients with STEMI in India

“…The design of NORIN‐STEMI has been previously described in detail 11 . Briefly, NORIN‐STEMI is a prospective, ongoing observational registry of all consenting adults (≥18 years of age) presenting with STEMI at two government‐owned, PCI‐capable tertiary care centres in New Delhi, India, from January 2019 to February 2020.…”

Secondary prevention of cardiovascular diseases in India: Findings from registries and large cohorts

“…The NORIN STEMI registry is a prospective cohort study based in two large, largely cost-free tertiary medical centers in New Delhi, India. 20 These institutions are government-funded and allow the inclusion of an underserved population. The goal of the study is to study risk factors (such as hypertension, hyperlipidemia, kidney disease, diabetes mellitus), practice patterns (such as duration from onset of symptoms to presentation and PCI), and prognosis of patients presenting with STEMI at these tertiary care hospitals.…”

“… Small sample size, short duration of follow up, convenient sampling and limited clinical endpoints. North Indian ST-Segment Elevation Myocardial Infarction (NORIN STEMI) Registry 20 2019 All patients >18 years of age presenting with STEMI at two tertiary care hospitals in India .n~3500 (data collected on 558 patients thus far) 45% of patients presented to the emergency department more than 1 h after symptom onset. More data to follow after further enrollment.…”