title: Organisation of reperfusion therapy for STEMI in a developing country.
abstract: Routine evaluation of performance measures for the system of care for patients with ST-elevation myocardial infarction (STEMI) is needed to improve the STEMI network. We sought to evaluate the current status of reperfusion therapy for STEMI in the capital city of a developing country where a STEMI network was introduced in 2010.
  
  
  
  Data were obtained from a local registry. A total of 28 812 patients admitted to the emergency department of a national cardiovascular hospital in three different periods (2007, 2010 and 2013) were retrospectively analysed; there were 2703 patients with STEMI.
  
  
  
  In 2013 compared with 2007, there was a major increase in the number of primary percutaneous coronary interventions (PCIs) (35% vs 24%, p<0.001), and the proportion of non-reperfused patients fell (62.8% vs 67.7%, p<0.001). An improvement in the overall STEMI mortality rate was also observed (7.5% vs 11.7%, p<0.001).
  
  
  
  Implementation of a regional system of care for STEMI may improve utilisation of primary PCI. Future organisation of reperfusion therapy in a developing country such as Indonesia strongly calls for a strategy that focuses on prehospital care to minimise delay from the first medical contact to reperfusion therapy, and this may reduce the proportion of non-reperfused patients. These strategies are in concordance with guideline recommendations and may reduce or eliminate gaps in healthcare in developing countries, particularly the underutilisation of evidence-based therapies for patients with STEMI.
  
  
  
  NCT 02319473, Clinicaltrials.gov.
authors.affiliation: Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia.
authors.forename: Surya
authors.initials: S
authors.lastname: Dharma
authors.affiliation: Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia.
authors.forename: Hananto
authors.initials: H
authors.lastname: Andriantoro
authors.affiliation: Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia.
authors.forename: Iwan
authors.initials: I
authors.lastname: Dakota
authors.affiliation: Chairman, Indonesian Heart Association, Jakarta Branch , Indonesia.
authors.forename: Ismi
authors.initials: I
authors.lastname: Purnawan
authors.affiliation: Department of Cardiology, Gatot Soebroto Army Central Hospital, Central Jakarta , Indonesia.
authors.forename: Vireza
authors.initials: V
authors.lastname: Pratama
authors.affiliation: Department of Cardiology and Vascular Medicine , Pasar Rebo General Hospital , East Jakarta , Indonesia.
authors.forename: Herawati
authors.initials: H
authors.lastname: Isnanijah
authors.affiliation: Integrated Cardiovascular Services, Cardiology Division, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo General Hospital, Central Jakarta , Indonesia.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Yamin
authors.affiliation: Department of Cardiology, Dr Mintohardjo Hospital, Indonesian Naval Hospital, Central Jakarta , Indonesia.
authors.forename: Tjatur
authors.initials: T
authors.lastname: Bagus
authors.affiliation: Binawaluya Cardiac Center, East Jakarta, Indonesia.
authors.forename: Benny
authors.initials: B
authors.lastname: Hartono
authors.affiliation: Department of Cardiology and Vascular Medicine , Tarakan General Hospital , Central Jakarta , Indonesia.
authors.forename: Endang
authors.initials: E
authors.lastname: Ratnaningsih
authors.affiliation: Department of Cardiology and Vascular Medicine, Christian University of Indonesia General Hospital, East Jakarta, Indonesia.
authors.forename: Frits
authors.initials: F
authors.lastname: Suling
authors.affiliation: Department of Cardiology and Vascular Medicine, Persahabatan Hospital, East Jakarta, Indonesia.
authors.forename: M Abas
authors.initials: MA
authors.lastname: Basalamah
keywords: CORONARY ARTERY DISEASE