Author + information
- Sameer Mehta1,
- Roberto Botelho2,
- Francisco Fernandez3,
- Marco Perin4,
- Cesar Dusilek5,
- Rodolfo Cardoso6,
- Juan Carlos Perez Alva7,
- Marco Alcocer-Gamba8,
- Daniel Rodriguez9,
- Isaac Yepes10 and
- Mario Torres11
- 1Lumen Foundation, Miami, Florida, United States
- 2Triangulo Heart Institute, Uberlândia, Minas Gerais, Brazil
- 3ITMS, Santiago, Chile
- 4Hospital Sírio-Libânes / Hospital Santa Marcelina, Sao Paulo, São Paulo, Brazil
- 5Hospital do Rocio, Campo largo, Paraná, Brazil
- 6HSCOR - Hospital do Coração de Duque de Caxias., Coracao, Rio de Janeiro, Brazil
- 7Instituto Cardiovascular de Puebla, Puebla, Puebla, Mexico
- 8Instituto de Corazón de Querétaro, Queretaro, Querétaro, Mexico
- 9Lumen Global, Miami, Florida, United States
- 10Lumen Foundation, plantation, Florida, United States
- 11Lumen Foundation, Lake Worth, Florida, United States
Tremendous disparities exist between developed and developing countries in the outcome of patients presenting with STEMI. Telemedicine is an effective strategy to reduce these differences. Latin America Telemedicine Infarct Network (LATIN) was conceived as a telemedicine based program for STEMI management, but it encountered vast challenges.
A hub and spoke strategy was used to maximize access to remote regions, often in difficult terrain, for the goal to expand the reach of the telemedicine umbrella to the poorest. A standardized protocol was used, with the spokes using a 3T (triage, telemedicine, transfer) strategy for urgent triage, and the hubs, performing definitive treatment, primarily PCI.
152 centers, as shown below, have been created after overcoming numerous challenges that are unique to the three countries of Brazil, Colombia and Mexico. 365,481 patients were screened, 4,271 STEMI (1.1%) diagnosed and 1,833 (54%) urgently treated (91% Primary PCI). Processes have improved and D2N, D2B, DIDO have been systematically reduced in all regions. However, several diagnosed patients are still not re-perfused in a timely fashion, reflecting ongoing challenges.
LATIN represents a massive, continent-wide, initiative with Amazonian possibilities of saving lives from STEMI.
OTHER: Political, International and Societal Issues