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学科主题: 临床医学
题名:
Stent for Life Initiative: leading example in building STEMI systems of care in emerging countries
作者: Kaifoszova, Zuzana1; Kala, Petr2,3; Alexander, Thomas4; Zhang, Yan5; Huo, Yong6,7; Snyders, Adriaan8; Delport, Rhena9; Alcocer-Gamba, Marco Antonio10,11; Gavidia, Leslie Marisol Lugo10,11
关键词: coronary artery disease ; emergency medical service ; primary percutaneous coronary intervention ; reperfusion ; ST-elevation acute myocardial infarction
刊名: EUROINTERVENTION
发表日期: 2014-08-01
DOI: 10.4244/EIJV10STA14
卷: suppl.S, 页:T87-T95
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: ACUTE MYOCARDIAL-INFARCTION ; PERCUTANEOUS CORONARY INTERVENTION ; MORTALITY ; DISEASE ; CHINA ; REPERFUSION ; MANAGEMENT ; REGISTRY ; MEXICO ; TRIAL
英文摘要:

This paper describes the opportunities and challenges in building ST-elevation acute myocardial infarction (STEMI) systems of care in Stent for Life affiliated and collaborating so-called emerging countries, namely India, China, South Africa and Mexico, where CAD mortality is increasing and becoming a significant healthcare problem. The Stent for Life model supports the implementation of ESC STEMI Guidelines in Europe and endeavours to impact on morbidity and mortality by improving services and developing regional STEMI systems of care, whereby STEMI patients′ timely access to a primary percutaneous coronary intervention (PPCI) is assured. In India, the STEMI India model incorporates a dual approach of combining PPCI with a pharmacoinvasive strategy of reperfusion. The architecture of the system is based on a hub and spoke model with each unit called a STEMI cluster. The project is driven by a private non-profit organisation. In China, the STEMI PCI programme is led by the Chinese College of Cardiovascular Physicians and supported by the national government. Although primary PCI is performed nationwide, a thrombolytic treatment strategy is still the first option in many rural areas because of logistic considerations. Establishing local STEMI transfer networks and then implementing a pharmacoinvasive strategy of reperfusion are being considered and promoted currently. In South Africa, the pharmacoinvasive approach currently dominates as STEMI treatment option in many areas. A pilot study shows that low symptom awareness leads to long patient delays. The education of all role players, from patients to healthcare professionals and including institutions and governmental structures, is needed to achieve prompt diagnosis and treatment. In Mexico, improving the treatment of STEMI requires considering myocardial infarction to be an emergency that must be treated by an entire system and not just by a particular service. Patients need to receive quick treatment from clinical and interventional cardiologists, and the emergency medical system (EMS) must understand the importance of early reperfusion therapy when appropriate. Mexican health authorities have used registries as their main strategy for improving the use of health resources for ACS patients. In general, building regional STEMI systems of care and an EMS system infrastructure are critical success factors in the stepwise development of STEMI systems of care at a national level in emerging countries as they are in Europe. An in-depth understanding of healthcare system-level barriers to timely and appropriate reperfusion therapy facilitates the development of more effective strategies for improving the quality of STEMI care in each region and country.

语种: 英语
WOS记录号: WOS:000343376600014
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54504
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 1.Kovai Med Ctr, Coimbatore, Tamil Nadu, India
2.Univ First Hosp, Dept Cardiol, Beijing, Peoples R China
3.Peking Univ, Hosp 1, Ctr Heart, Beijing 100871, Peoples R China
4.HELIS Partners Consulting, Prague, Czech Republic
5.Masaryk Univ, Brno, Czech Republic
6.Univ Hosp Brno, Brno, Czech Republic
7.Peking Univ, Hosp 1, Dept Cardiol, Beijing 100871, Peoples R China
8.Wilgers Hosp, Pretoria, Gauteng, South Africa
9.Univ Pretoria, Dept Chem Pathol, Pretoria, Gauteng, South Africa
10.Autonomous Univ Queretaro, Fac Med, Queretaro, Mexico
11.Heart Inst Queretaro, Queretaro, Mexico

Recommended Citation:
Kaifoszova, Zuzana,Kala, Petr,Alexander, Thomas,et al. Stent for Life Initiative: leading example in building STEMI systems of care in emerging countries[J]. EUROINTERVENTION,2014,suppl.S:T87-T95.
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