wow-inequalities/02-data/intermediate/wos_sample/fcb84234020a76c33174e40895cccf2f-alexander-thomas-an/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Introduction: Over the past two decades, India has witnessed a
staggering increase in the incidence and mortality of ST-elevation
myocardial infarction (STEMI). Indians have higher rates of STEMI and
younger populations that suffer from it when compared with developed
countries. Yet, the recommended reperfusion therapy with fibrinolysis
and percutaneous coronary intervention is available only to a minority
of patients. This gap in care is a result of financial barriers, limited
healthcare infrastructure and poor knowledge and accessibility of acute
medical services for a majority of its population.
Methods and analysis: This is a prospective, multicentre,
`pretest/post-test'' quasi-experimental, community-based study. This
programme will use a `hub-and-spoke'' model of an integrated healthcare
network based on clusters of primary-care health clinics, small
hospitals and large tertiary-care facilities. It is an `all-comers''
study which will enrol consecutive patients presenting with STEMI to the
participating hospitals. The primary objectives of the study is to
improve the use of reperfusion therapy and reduce the time from first
medical contact to device or drug in STEMI patients; and to increase the
rates of early invasive risk stratification with coronary angiography
within 3-24 h of fibrinolytic therapy in eligible patients through
changes in process of care. Outcomes will be measured with statistical
comparison made before and after implementing the TN-STEMI programme.
The estimated sample size is based on the Kovai Erode Pilot study, which
provided an initial work on establishing this type of programme in South
India. It will be adequately powered at 80\% with a superiority margin
of 10\% if 36 patients are enrolled per cluster or 108 patients in three
clusters. Thus, the enrolment period of 9 months will result in a sample
size of 1500 patients.
Ethics: This study will be conducted in accordance with the ethical
principles that have their origin in the current Declaration of Helsinki
and `ethical guidelines for biomedical research on human participants''
as laid down by the Indian Council for Medical Research. All
participating hospitals will still obtain local ethics committee
approval of the study protocol and written informed consent will be
obtained from all participants.
Dissemination and results: Our findings will be reported through
scientific publications, research conferences and public policy venues
aimed at state and local governments in India. If successful, this model
can be extended to other areas of India as well as serve as a model of
STEMI systems of care for low-income and middle-income countries across
the world.'
affiliation: 'Alexander, T (Corresponding Author), Kovai Med Ctr \& Hosp, Dept Intervent
Cardiol, Coimbatore, Tamil Nadu, India.
Alexander, Thomas, Kovai Med Ctr \& Hosp, Dept Intervent Cardiol, Coimbatore, Tamil
Nadu, India.
Victor, Suma M.; Mullasari, Ajit S., Madras Med Mission Hosp, Dept Intervent Cardiol,
Madras, Tamil Nadu, India.
Veerasekar, Ganesh, Kovai Med Ctr \& Hosp, Dept Epidemiol, Coimbatore, Tamil Nadu,
India.
Subramaniam, Kala, Lotus Clin Res Acad Pvt Ltd, Clin Res, Madras, Tamil Nadu, India.
Nallamothu, Brahmajee K., Univ Michigan, Ann Arbor, MI 48109 USA.'
article-number: e003850
author: Alexander, Thomas and Victor, Suma M. and Mullasari, Ajit S. and Veerasekar,
Ganesh and Subramaniam, Kala and Nallamothu, Brahmajee K. and Investigators, TN-STEMI
Programme
author-email: tomalex41@gmail.com
author_list:
- family: Alexander
given: Thomas
- family: Victor
given: Suma M.
- family: Mullasari
given: Ajit S.
- family: Veerasekar
given: Ganesh
- family: Subramaniam
given: Kala
- family: Nallamothu
given: Brahmajee K.
- family: Investigators
given: TN-STEMI Programme
da: '2023-09-28'
doi: 10.1136/bmjopen-2013-003850
files: []
issn: 2044-6055
journal: BMJ OPEN
keywords-plus: HEART
language: English
number: '12'
number-of-cited-references: '9'
papis_id: ec821bf07ff47f3e9a08c939faa4681e
ref: Alexander2013protocolprospective
times-cited: '17'
title: 'Protocol for a prospective, controlled study of assertive and timely reperfusion
for patients with ST-segment elevation myocardial infarction in Tamil Nadu: the
TN-STEMI programme'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000330541400019
usage-count-last-180-days: '0'
usage-count-since-2013: '4'
volume: '3'
web-of-science-categories: Medicine, General \& Internal
year: '2013'