The national programme has had a trial run in Tamil Nadu, and will soon be taken to other states
India will soon have a customised national heart attack management programme of its own that will gradually be integrated in national health policy.
After preparing the programme and evaluating the trial run in Tamil Nadu, the Indian Council of Medical Research (ICMR) is planning to take the project to other states. "ST-Segment Elevation Myocardial Infarction (STEMI), run by cardiologists in Tamil Nadu will be looking after the project. STEMI India has published their results in Journal of the American Medical Association (JAMA) Cardiology this week, the results of which are encouraging. The Ministry of Health and Family Welfare (MoHFW) will make it a part of the national programme. We are already in talks with 18 states to adopt this model," said Dr S Meenakshi, Scientist, ICMR.
The 'STEMI India Model' has shown a significant reduction in mortality and major adverse cardiac events (MACE) in the implementation phase when compared to the pre-implementation phase in the Tamil Nadu (TN) STEMI programme.
The trial project created an integrated, regional quality improvement programme that linked the 35 sub-centres to the four large PCI hospitals. It leveraged recent developments in public health insurance schemes, emergency medical services, and health information technology. A total of 2,420 patients are enrolled with STEMI and the study showed that the programme may prevent mortality.
"Cost-Effectiveness Analysis as per World Health Organisation (WHO) methods indicates that STEMI India Model is efficacious, effective and cost-effective as compared to the 'no intervention' case. The STEMI India model may be adopted as the National STEMI Programme," said Dr Thomas Alexander, Director, STEMI India, Kovai Medical Center and Hospital, Coimbatore.
The programme would be funded by the State Government. The states will prepare a Project Implementation Plan under National Health Mission along with costing of the project for implementation in their respective states.
The Non Communicable Diseases (NCD) cell at Union Health Ministry and ICMR will provide support in these activities. The STEMI India team will train the paramedics and staff in the hospitals and ambulances in using STEMI Kit as well as in the Protocol.
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 programme in India a daunting task.
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