A reduction in the number of interventional cardiology procedures has emerged as a result of the COVID-19 pandemic. A survey was performed to quantify this decrease and the impact on the management of myocardial infarction in Latin America.
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.
A cross-sectional descriptive study based on aggregated country-level data on the use of reperfusion therapy in patients admitted with STEMI during 2010 or 2011. Large variations in reperfusion treatment are still present across Europe. Countries in Eastern
and Southern Europe reported that a substantial number of STEMI patients are not receiving any reperfusion therapy. Implementation of the best reperfusion therapy as recommended in the guidelines should be encouraged.
Due to significant improvement in the pre-hospital treatment of patients with out-of-hospital cardiac arrest (OHCA), an increasing number of initially resuscitated patients are being admitted to hospitals. Because of the limited data available and lack
of clear guideline recommendations, experts from the EAPCI and “Stent for Life” (SFL) groups reviewed existing literature and provided practical guidelines on selection of patients for immediate coronary angiography (CAG), PCI strategy, concomitant
antiplatelet/anticoagulation treatment, haemodynamic support and use of therapeutic hypothermia.
In Italy, as in other European countries, public service healthcare presents some disparities that are related to geographical, economic, organizational and structural issues. Although some Italian regions have excellent networks for the treatment of
ST-elevation myocardial infarction (STEMI), others still have to develop a model that allows each STEMI patient to receive the best reperfusion treatment. A recent nationwide registry from the Italian Society of Interventional Cardiology (SICI-GISE)
showed that efficient STEMI networks cover approximately 50% of the Italian territory. For these reasons, Italy joined the Stent for Life initiative in August 2010 with the primary goal of implementing and defining tailored action programs in order
to ensure that the majority of the Italian STEMI population have access to life-saving primary percutaneous coronary intervention.
Since SFL was launched, several activities have been initiated in the participating countries. Preliminary reports suggest that major increases have been seen in the numbers of PPCI performed, with some countries reporting very significant increases in
PPCI use from 2008-2010. Improvements in STEMI mortality rates have also been observed. This report summarises the progress of the SFL initiative in the 10 target countries.
Three countries – Egypt, Italy and Romania – have recently announced that they are joining the Stent for Life initiative, according to news from the European Society of Cardiology Congress 2010. Each country involved in the initiative is implementing
an action program to increase patient access to primary PCI, with the following targets: 1) increase the use of primary PCI to more than 70% among all STEMI patients; 2) achieve primary PCI rates of more than 600 per one million inhabitants per year;
and 3) offer a 24/7 service for PCI procedures at all invasive facilities to cover the need of the country’s STEMI population.
Early revascularization with primary percutaneous coronary intervention (PPCI) in patients with ST-elevation myocardial infarction (STEMI) has been shown to reduce mortality, rates of nonfatal reinfarction and stroke, as compared to previous standard
of care with thrombolytic therapy. Despite substantial evidence of its effectiveness, the use of PPCI varies considerably across Europe. The Stent for Life Initiative supports implementation of local STEMI treatment guidelines, helps to identify specific
barriers to implementation of guidelines and defines actions to make sure that the majority of STEMI patients have access to PPCI. Launching a successful programme for PPCI requires the commitment and collaboration of a broad variety of members of the
healthcare system. This narrative review is intended to describe some of the progress already seen in the 10 countries currently included in the Stent for Life Initiative and to report and discuss the engagement of the various stakeholders involved.