Prevalence of ST-Segment Elevation Myocardial Infarction (STEMI) in Pakistan and the Role of Primary Percutaneous Coronary Intervention (PPCI)

Abstract

There are various strategies used for treating ST-segment elevated myocardial infarction (STEMI). Among those approaches, Primary percutaneous coronary intervention (PPCI) is the current treatment of choice for STEMI as it reperfuses the ischaemic cardiac tissue with fewer reported adverse events and a better survival rate. Although thrombolytic therapy is still used for STEMI in approximation, the benefits of PPCI outweigh thrombolytic therapy as thrombolytic therapy is associated with higher bleeding events and higher morbidity. The barriers in implementing a PPCI program and regional differences arise due to limited technologies, lack of proper training of first responders, lack of public awareness, and transport facilities and finances. Therefore, treatment varies between different regions of countries and even between different countries, including Pakistan. PPCI should be used in a timely manner as delayed use of this intervention can significantly reduce the benefits. We lack a coordinated approach to the delivery of this system in Pakistan; mainly, the paramedical staff is not fully familiarised and trained for making a definite diagnosis and lacks referral portals. We need a comprehensive approach and program to identify factors that cause a delay in providing PPCI to STEMI patients and to eliminate the factors responsible for the delay. This will help in improving the survival rate morbidity in STEMI patients.