Buoyed by the success in reducing the death rate due to heart attacks in rural areas, the state health department will soon launch the second phase of the ST-Elevation Myocardial Infarction (STEMI) heart attack programme that aims to ensure treatment in the golden hour.
The programme is designed in a hub-and-spoke model, wherein tertiary hospitals with catheterisation lab function as hubs, and taluk and district hospitals as spokes.
While in the first phase, 15 districts were covered with 45 spokes and three hub hospitals, in the second phase, the health department aims to cover another 15 districts with eight hubs (Dakshina Kannada, Udupi, Belagavi, Davangere, Shivamogga, Dharwad, Bagalkot, and Ballari) as cardiac cath lab centres connected to 41 spoke hospitals. The second phase is expected to be launched in February.
Pointing out that a heart care programme is the need of the hour in rural areas, Dr C N Manjunath, Sri Jayadeva Institute of Cardiovascular Sciences and Research which is the main hub hospital in phase one, said that STEMI had brought down the death rate significantly in the areas where it was implemented in the first phase.
“The incidents of heart disease among the rural and semi-urban population have increased drastically over the last few decades owing to the change in lifestyle. This change needs to be addressed and hence the programme is significant. The risk of death increases by 7% for every 30-minute delay. The survival rate is high when treated within three hours,” he explained.
To ensure the doctors can buy time to refer critical patients to tertiary care centres, the programme includes the administration of clot-dissolving medicines. In the first phase, the government had procured only Streptokinase and this will be replaced with Tenecteplase in phase two.
“There were concerns that Streptokinase is tough to administer. Also, Tenecteplase is said to be more effective. Hence, we have decided to include Tenecteplase in phase two,” said Randeep D, Commissioner, Department of Health and Family Welfare.
“Once a clot-dissolving drug is administered, the doctors get 24 hours to start other treatment. In that time, the patients can be stabilised and moved to tertiary care centres,” Dr Manjunath added.
In the second phase, the department will also procure Automated External Defibrillator (AED) devices to be placed in public places, such as bus stations, railway stations, airports, court complexes, and government offices.
Phase one was launched in March 2023, and so far 1.01 lakh patients from the rural areas have been screened. A total of 1.04 lakh ECGs were performed and 1,704 patients were confirmed to have had a heart attack. Close to 6,155 of them were diagnosed with various heart diseases.
According to an estimate, in Karnataka, close to 96,150 patients are affected by severe heart attacks (STEMI) causing sudden deaths every year.