Overview
Video Discussion with Dr. Thomas Alexander
In a recent video, Dr. Thomas Alexander, a distinguished cardiologist and Senior Interventional Cardiologist at Kovai Medical Center and Hospital in Coimbatore, Tamil Nadu, addresses a significant paper featured in the August 2025 issue of the European Heart Journal: Acute Cardiovascular Care.
Key Focus of the Paper
The paper, titled “Reperfusion Therapy for STEMI in Low- to Middle-Income Countries: A Clinical Consensus Statement,” is a collaborative initiative involving several organizations, including the Association for Acute CardioVascular Care (ACVC), European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Association of Preventive Cardiology (EAPC), the ESC Working Group on Thrombosis, and the Stent – Save a Life! Initiative.
Despite advancements in medical care, the management of ST-elevation myocardial infarction (STEMI) remains inadequate in many low- and middle-income countries (LMICs). Data from registries in regions such as Latin America, Africa, and Asia indicate that less than 65% of patients receive timely reperfusion therapy. This consensus statement aims to provide a practical framework to enhance STEMI care systems and address existing treatment deficiencies.
Key Questions Addressed by Dr. Alexander
Dr. Alexander discusses several pertinent questions regarding the future of STEMI care:
1. What would a “successful STEMI network” in India look like in the next 3-5 years? What collaborative roles should interventional cardiologists, governments, and the industry play to realize this vision?
2. The paper presents three flexible models of treatment: thrombolysis-only, pharmaco-invasive, and primary PCI. Which model strikes the best balance between feasibility and clinical impact for resource-constrained areas?
3. What specific challenges or gaps in LMICs, particularly in India, led to the creation of this consensus statement?
4. What message does Dr. Alexander have for young cardiologists aspiring to bridge the gap between evidence-based practices and access to cardiovascular care?
About the Speakers
Dr. Thomas Alexander, MD, DM, FACC, FICC, FCSI, is an Interventional Cardiologist and the Head of the Division of Cardiology at Kovai Medical Center and Hospital in Coimbatore, India. He is also the Course Director of the STEMI India meeting, an international conference focused on STEMI management. Additionally, Dr. Alexander is a member of the India Editorial Advisory Board at mdCurrent, LLC, and a founding trustee of STEMI-INDIA, a non-profit organization dedicated to improving STEMI management, training teams, and developing national guidelines.
Dr. Nandita Mohan is a practicing pediatric dentist with over five years of clinical experience. She remains committed to staying informed about the latest advancements in medicine and dentistry, which has motivated her collaboration with Medical Dialogues. Dr. Mohan holds a BDS from Rajiv Gandhi University of Health Sciences, Bangalore, and completed her MDS in Pedodontics and Preventive Dentistry at Pt. B.D. Sharma University of Health Sciences. Her passion for continuous learning drives her ongoing professional development. She can be reached at [email protected] or by phone at 011-43720751.