Implementation of a hub and spoke STEMI Goa project – Initial results, gains and challenges

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dc.contributor.authorNaik, Guruprasaden_US
dc.contributor.authorPrabhudesai, Amaren_US
dc.contributor.authorMalali, Venkateshen_US
dc.contributor.authorParab, Michelle Viegasen_US
dc.contributor.authorQuadros, Joelen_US
dc.contributor.authorVaidya, Pankajamen_US
dc.contributor.authorD’Mello, Edwarden_US
dc.contributor.authorArsekar, Swapnilen_US
dc.contributor.authorValaulikar, Radhaen_US
dc.date.accessioned2025-08-13T11:15:21Z
dc.date.available2025-08-13T11:15:21Z
dc.date.issued2025-04
dc.description.abstractObjectives: To study the impact of a ‘hub and spoke’ STEMI management programme on delivery of thrombolysis in the state of Goa. Methods: A prospective observational study was conducted to assess the ‘hub and spoke’ model STEMI pro- gramme in the state of Goa. Data was collected using predesigned proformas filled at Primary Health Centres or District Hospitals which served as the spokes. Primary programme efficacy outcomes studied were the proportion of eligible patients of STEMI receiving thrombolysis and the time to thrombolysis. Secondary outcome assessed was in-hospital mortality. Results: A total of 2050 number of patients were diagnosed with STEMI between November 2019 and March 2022, of which complete data was available for 1325 patients. After ruling out contraindications, delayed pre- sentations or refusal for treatment, 74.3 % of STEMI patients received thrombolysis. The median window period was 130.83 min with an interquartile range (IQR) of 159.63 min. The median time from presentation to recording ECG was 7.9 (IQR = 11.63) minutes and presentation to cloud diagnosis was 11.78 (IQR = 12.96) minutes. The median time from presentation to administering thrombolysis (Door to Needle time) was 18.48 (IQR = 28.85) minutes. Only 0.22 % patients received inappropriate thrombolysis and the in-hospital mortality was 9.4 %. Conclusion: A STEMI programme utilizing the existing manpower and primary health care setup improved ‘secondary’ level of care to patients by providing thrombolysis to a high percentage of patients in quick time. This may serve as a model to improve the outreach of reperfusion therapy in a resource challenged country like India.en_US
dc.identifier.affiliationsDepartment of Cardiology, Goa Medical College, Bambolim, Goa, 403202, Indiaen_US
dc.identifier.affiliationsDepartment of Cardiology, Goa Medical College, Bambolim, Goa, 403202, Indiaen_US
dc.identifier.affiliationsDepartment of Cardiology, Goa Medical College, Bambolim, Goa, 403202, Indiaen_US
dc.identifier.affiliationsDepartment of Cardiology, Goa Medical College, Bambolim, Goa, 403202, Indiaen_US
dc.identifier.affiliationsDepartment of Cardiology, Goa Medical College, Bambolim, Goa, 403202, Indiaen_US
dc.identifier.affiliationsDepartment of Cardiology, Goa Medical College, Bambolim, Goa, 403202, Indiaen_US
dc.identifier.affiliationsSouth Goa District Hospital, Margao, Goa, Indiaen_US
dc.identifier.affiliationsNorth Goa District Hospital, Mapusa, Goa, Indiaen_US
dc.identifier.affiliationsNational Program for NCDs, National Health Mission-Goa, Indiaen_US
dc.identifier.citationNaik Guruprasad, Prabhudesai Amar, Malali Venkatesh, Parab Michelle Viegas, Quadros Joel, Vaidya Pankajam, D’Mello Edward, Arsekar Swapnil, Valaulikar Radha. Implementation of a hub and spoke STEMI Goa project – Initial results, gains and challenges. Indian Heart Journal. 2025 Apr; 77(2): 67-72en_US
dc.identifier.issn0019-4832
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/253345
dc.languageenen_US
dc.publisherElsevieren_US
dc.relation.issuenumber2en_US
dc.relation.volume77en_US
dc.source.urihttps://doi.org/10.1016/j.ihj.2025.02.004en_US
dc.subjectST elevation myocardial infarction (STEMI)en_US
dc.subjectThrombolysisen_US
dc.subjectHub and spokeen_US
dc.subjectCloud ECGen_US
dc.titleImplementation of a hub and spoke STEMI Goa project – Initial results, gains and challengesen_US
dc.typeJournal Articleen_US
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