Reperfusion of myocardial infarction in India: Notions for México

Abstract

In India and México, cardiovascular diseases are the first cause of death and potential years of life lost. Close similarities exist between these two countries when facing the difficulties to establish a universal reperfusion program for ST elevation myocardial infarction (STEMI). This paper describes the situation of STEMI treatment in both countries, and examines the lessons that Mexico's health care system could adopt from the recent advances accomplished by the STEMI initiative in India.

A Systematic Review of the Efficacy and Safety of Tenecteplase Versus Streptokinase in the Management of Myocardial Infarction in Developing Countries

“…PCI is not readily available in developing countries in all healthcare settings [ 6 ]. In India, less than 10% of patients presenting with MI are treated with PCI due to the unavailability of cath labs and transportation delays [ 7 ]. The same applies to most developing countries.…”

“…The same applies to most developing countries. On the other hand, those who present early have insufficient funds because of a lack of health insurance [ 7 ]. Patients in most resource-poor nations pay out of pocket for hospital bills, and most hospitals that offer PCI procedures belong to the private sector without influence from the central government [ 7 ].…”

“…On the other hand, those who present early have insufficient funds because of a lack of health insurance [ 7 ]. Patients in most resource-poor nations pay out of pocket for hospital bills, and most hospitals that offer PCI procedures belong to the private sector without influence from the central government [ 7 ]. The Acute Coronary Event Strategies Survey (ACCESS Registry) trial conducted in nine developing countries noted that only 20% of cases of ST-elevation MI (STEMI) are managed with PCI [ 6 ].…”

Evaluation of pharmacoinvasive strategy versus percutaneous coronary intervention in patients with acute myocardial infarction with ST-segment elevation at the National Institute of Cardiology (PHASE-MX)

“…The advantage of this strategy allows easy access to fibrinolytic 8 combined with percutaneous transluminal coronary angioplasty efficacy to prevent reinfarction and recurrent ischemia 3 . The pharmacoinvasive strategy has been shown not to be inferior in prospective clinical studies 7,9 and real-life registries 10 , and multiple countries have published their experience with regard to pharmacoinvasive systems 11 .…”

Evaluación de la estrategia farmacoinvasiva versus angioplastia coronaria transluminal percutánea primaria en pacientes con infarto agudo de miocardio con elevación del segmento ST en el Instituto Nacional de Cardiología (PHASE-MX)

“…La estrategia farmacoinvasiva consiste en fibrinólisis inmediata y coronariografía sistemática subsecuente, preferentemente en las primeras 3 a 24 horas después de la fibrinólisis 7 . La ventaja de esta conducta permite el fácil acceso al fibrinolítico 8 combinada con la eficacia de la angioplastia coronaria transluminal percutánea para prevenir el reinfarto y la isquemia recurrente 3 .La estrategia farmacoinvasiva ha demostrado no ser inferior en estudios clínicos prospectivos 7,9 , y registros de la vida real 10 , y múltiples países han publicado su experiencia en relación con sistemas de farmacoinvasión 11 .…”