Expert consensus document on management of ST-Elevation myocardial infarction: Adaptation of 2012 ESC guidelines

Coronary artery disease (CAD) is a major contributor to morbidity and mortality in India, and its overall prevalence has risen dramatically over the past two decades. It has been seen that patients in India who suffer from Acute Coronary Syndrome (ACS) are younger (mean age, 56.3 years) and ST-elevation myocardial infarction (STEMI), constitute a higher proportion (60.6%) of ACS compared to non-ST elevation MI (NSTEMI). While these are erudite and exhaustive, they are tailored to the situation in developed countries. Although no evidence-based guidelines in India exists, an expert consensus on the management of STEMI provide some India specific recommendations. As there are differences between European and Indian settings regarding the availability of percutaneous coronary intervention (PCI) centers, initial delay in reperfusion, acceptability of concept of pre-hospital thrombolysis, 24 7 availability of trained staff, patient factors and financial challenges, the applicability of the recent ESC guidelines need to be critically looked at to adapt the recommendations in Indian setting. The objective of this expert consensus was to take the ESC 2012 STEMI guideline and tweak it with available Indian evidence by the help of a group of acclaimed Indian experts on the subject to provide a consensus document relevant for Indian STEMI patients which can provide a framework to guide Indian physicians and healthcare providers in making decisions for the optimal management of patients with STEMI.