Reperfusion Therapy for STEMI in LMICs: A Clinical Consensus Discussion with Dr Thomas Alexander
In this video, renowned cardiologist Dr Thomas Alexander, Senior Interventional Cardiologist and Head of the Division of Cardiology at Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, discusses a recent paper published in the European Heart Journal: Acute Cardiovascular Care (August 2025 issue).The paper, titled “Reperfusion Therapy for STEMI in Low- to Middle-Income Countries: A Clinical Consensus Statement”, represents a joint effort by the Association for Acute CardioVascular Care (ACVC), European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Association of Preventive Cardiology (EAPC), the ESC Working Group on Thrombosis, and the Stent – Save a Life! Initiative.Despite advancements, ST-elevation myocardial infarction (STEMI) care remains suboptimal in many low- and middle-income countries. Registries from Latin America, Africa, and Asia reveal that fewer than 65% of patients receive timely reperfusion therapy. This consensus statement offers a practical framework to strengthen STEMI systems of care and bridge existing treatment gaps.He answers the following questions:1) What would a “successful STEMI network” in India look like in the next 3- 5 years? And what collaborative roles should interventional cardiologists, governments, and industry play to make it happen?2) The paper proposes a flexible three-model pathway — thrombolysis-only, pharmaco-invasive, and primary PCI models. Which model offers the best balance between feasibility and clinical impact for resource-limited regions?3) What specific gaps or on-ground challenges in LMICs, such as India, prompted the development of this consensus statement?4) Message for young cardiologists who aspire to bridge the gap between evidence and access in cardiovascular care
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