TN Model in Heart Attack Care

Why in news?

A unique model of heart attack care has brought down the time taken respond to cardiac episodes from 900 minutes to 170 minutes in Tamil Nadu.

What the new study says?

• The yearlong study has been funded by the Indian Council of Medical Research (ICMR).
• The landmark study, reduces the symptom-to-door time by effective, early and rapid reperfusion — restoring blood flow through blocked arteries, typical after a heart attack.

How the traditional treatment is done?

• Traditionally, a heart attack is treated by two strategies of re-perfusion.
• If a patient arrives at a hospital equipped with a catheterisation laboratory or ‘cath lab’, a procedure known as Primary PCI (Percutaneous Coronary Intervention) is performed — an urgent balloon angioplasty.
• The patient is then ‘Thrombolysed’ — treated to dissolve clots in blood vessels, improve blood flow, and prevent damage to tissues and organs before being discharged.

How the new model works?

• In the new model, STEMI India, a not-for-profit organisation, use the pharmaco invasive strategy, which can be administered in any small hospital or even in the ambulance.
• The Classic STEMI India model has a hub hospital, where a cath lab is available and primary PCI is done for patients directly presented at these hospitals.
• These are linked to peripheral spoke hospitals, where thrombolysis is done following which the patient is shifted within three to 24 hours to the hub hospital for invasive treatment.
• Data was collected from the four hub hospitals and 35 spoke hospitals, before and after the implementation of the heart attack programme.
• The pre-implementation data collection was for an average period of 15 weeks and the post implementation period of 32 weeks.
• As a result of the study, there was a steep increase in the rural poor using Below-Poverty-Line (BPL) insurance schemes to access the STEMI system.

Way ahead:

• Any heart attack treatment programme 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.

Source: The Hindu