Resource and Infrastructure-Appropriate Management of ST-Segment Elevation Myocardial Infarction in Low- and Middle-Income Countries.

Circulation
Y ChandrashekharJagat Narula

Abstract

The 143 low- and middle-income countries (LMICs) of the world constitute 80% of the world's population or roughly 5.86 billion people with much variation in geography, culture, literacy, financial resources, access to health care, insurance penetration, and healthcare regulation. Unfortunately, their burden of cardiovascular disease in general and acute ST-segment-elevation myocardial infarction (STEMI) in particular is increasing at an unprecedented rate. Compounding the problem, outcomes remain suboptimal because of a lack of awareness and a severe paucity of resources. Guideline-based treatment has dramatically improved the outcomes of STEMI in high-income countries. However, no such focused recommendations exist for LMICs, and the unique challenges in LMICs make directly implementing Western guidelines unfeasible. Thus, structured solutions tailored to their individual, local needs, and resources are a vital need. With this in mind, a multicountry collaboration of investigators interested in LMIC STEMI care have tried to create a consensus document that extracts transferable elements from Western guidelines and couples them with local realities gathered from expert experience. It outlines general operating principles for LM...Continue Reading

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Citations

Sep 5, 2020·Circulation. Cardiovascular Interventions·Pedro Engel GonzalezDharam J Kumbhani
Dec 12, 2020·Expert Review of Cardiovascular Therapy·Nasheeta PeerAndre-Pascal Kengne
Apr 17, 2021·Journal of the American College of Cardiology·Harold L Dauerman, Borja Ibanez
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Jul 28, 2021·The American Journal of Cardiology·Byomesh TripathiSaurav Chatterjee
Aug 28, 2021·European Heart Journal. Acute Cardiovascular Care·Ply ChichareonSaranyou Suwanugsorn

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