Landmark Trial in Tamil Nadu Reduces Mortality Due to Heart Attack – TN STEMI Program Shows the Way Forward for a National Heart Attack Program

Introduction

India is a large country with a very high burden of non-communicable disease, particularly cardiovascular diseases. It is estimated that there are over 60 million patients with heart disease in India with over 2 million heart attacks every year. The low rates of healthcare spending by the state and national governments, uneven distribution of basic healthcare facilities, and the inability of large populations of rural and urban poor to access high-quality care makes the challenge of developing a viable heart attack program in India a daunting task.

Added to this is the disproportionately high prevalence of coronary artery disease in lower socioeconomic classes and consequent higher mortality due to poor access to affordable, high-quality health care. All these challenges toward acute treatment need to be balanced against additional health priorities toward prevention, and this scenario in India represents a prototypical case for many low- and middle-income countries.

Any heart attack treatment program in India should consider the huge manpower and Infrastructure deficiencies that exist in India. Blindly following the American or European system would not be feasible in this country. Furthermore, any heart attack management system developed in India could be used in other low- and middle-income countries that are confronted by similar magnitude of disease as well as financial and manpower constraints.

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