Role of thrombolysis in reperfusion therapy for management of AMI: Indian scenario

Cardiovascular disorders are the major cause of morbidity & mortality globally as well in India. In 2008, out of the 57 million deaths globally; around 63% (i.e., nearly 30 million deaths) were due to non-communicable diseases.1 Cardiovascular diseases accounts for nearly half of the deaths due to non-communicable diseases worldwide, thus becoming the leading cause of death due to non-communicable diseases. Approximately, 80% of these deaths have been reported to occur in low and middle-income countries.1 Moreover, out of nine million premature deaths due to non-communicable diseases (viz. age < 60 years); around eight million occurred in low and middle-income countries. With 6.8% and 5.0% of disability-adjusted life-years (DALYs) lost, CAD is the second largest causes of disease burden in population aged 15 years and older globally.1 1.1. Trends of cardiovascular diseases in India Cardiovascular diseases have assumed epidemic proportions in India as well. The Global Burden of Diseases (GBD) study reported the estimated mortality from coronary heart disease (CHD) in India to be 1.6 million in the year 2000 which is estimated to increase to ∼64 million by the year 2015.2 The projected rise in disease burden due to CVD is expected to make it the prime contributor of total mortality and morbidity.2 Reports on CAD in Indians have shown that Asian Indians are at 3–4 times higher risk of CAD than white Americans, 6 times higher than Chinese, and 20 times higher than Japanese.3 Various independent epidemiological studies conducted in North India suggest that the prevalence of CAD has increased from 1% in 1960 to 10.5% in 1998 in the urban population.3 A higher prevalence of CAD, ranging from 11.0% to 14.2%, has been reported from South India.3 Taking into account the size of the Indian population, these prevalence rates indicate that a large number of deaths can be attributed to CAD.3