CHANDIGARH- To mark National Doctors’ Day, Punjab Health and Family Welfare Minister Dr Balbir Singh on Tuesday, inaugurated the statewide expansion of the Punjab STEMI Project, empowering all the district and sub-divisional hospitals in 23 districts to quickly intervene and give thrombolysis treatment by administering a clot buster drug Tenecteplase to save patient life in case of heart-attack.
This ambitious initiative, also known as "Mission Amrit" (Acute Myocardial Reperfusion In Time), aims to dramatically improve outcomes for patients experiencing ST-segment Elevated Myocardial Infarction (STEMI), the most severe type of heart attack.
Dr Balbir Singh accompanied by Principal Secretary Health Kumar Rahul and Professor & Head of Cardiology at DMCH Ludhiana Dr Bishav Mohan, while launching the project here, said that the Tenecteplase injection, which costs around Rs 30, 000, is being administered free of cost under this project. This injection helps to dissolve blood clots in the heart, he added.
The project was launched across the state after the success of a pilot project, which was initially implemented in two districts— Ludhiana and Patiala— and extended to nine more districts later. In the pilot stage, approximately 14, 000 chest pain patients have been enrolled, and out of 1305 STEMI patients identified, 583 have successfully received thrombolysis at district health facilities.
Speaking about the need of the project Dr Balbir Singh said that historically, patients in Punjab suffering from chest pain faced critical delays, often reaching a first medical contact an average of 2-3 hours after symptom onset. Many local hospitals and nursing homes lack the immediate diagnostic and treatment capabilities for STEMI, resulting in further delays in transferring the patient. This frequently pushed patients beyond the crucial "therapeutic window period” or Golden Hour for thrombolysis, a clot-busting therapy vital for restoring blood flow to the heart.
Sharing more details about the STEMI project, the Health Minister said that this project directly addresses these challenges through an innovative Hub and Spoke Model. District and Sub-Divisional Hospitals will serve as "Spoke" centres, equipped to handle initial diagnosis and management of STEMI patients. These Spoke centres are seamlessly integrated with expert "Hub" hospitals – including the existing DMCH Ludhiana and GMCH-32 Chandigarh, and four new hubs including Government Medical Colleges of Patiala, Faridkot, Amritsar and AIIMS Bathinda.
"Upon arrival at a Spoke centre, STEMI patients will receive primary management, including thrombolysis, under the direct guidance of experts from the nearest Hub via tele-ECG based consultation. Crucially, the thrombolytic drug, Injection Tenecteplase 40 mg (TNK 40 mg), will be provided free of cost at all district health facilities, eliminating financial barriers to immediate, life-saving treatment. Following stabilization, patients will be transferred to the Hub centers for further expert opinion and comprehensive treatment, ” he added.
Terming it as a monumental day for healthcare in Punjab, Dr Balbir Singh said, "The Punjab STEMI Project, building on the success of our ICMR pilot in SAS Nagar Mohali and Ludhiana, is a testament to our commitment to ensuring that every citizen, regardless of their location, has access to timely and effective care during a heart attack. By bringing thrombolysis directly to the district level, we are closing critical time gaps and significantly increasing the chances of survival and recovery for our patients."
To ensure the project's success the Health Minister said that over 700 staff members, including Medical Specialists, Emergency Medical Officers (EMOs), and Staff Nurses from all 23 districts, have undergone intensive capacity-building training programs at DMCH Ludhiana under the guidance of expert cardiologist Dr Bishav Mohan. All emergency rooms in hospitals have been equipped with ECG and defibrillators for management of STEMI cases.
Dr Bishav Mohan, Professor & Head of Cardiology at DMCH Ludhiana said that people need to be sensitised about the symptoms of heart attack, which usually people confuse with gastrointestinal problems and ignore. "The ischemic heart disease is the leading cause of death in India. This collaborative approach ensures that patients receive the most advanced treatment within the golden hour, improving their chances of survival, ” he added.
On the occasion, 12 doctors from across the state, who have successfully thrombolysed the patients within the timeframe were felicitated by the Health Minister.
Among others, State Information Commissioner Adv Harpreet Sandhu, Special Secretary Health-cum-MD NHM Ghanshyam Thori, MD PHSC Amit Talwar, Director Health and Family Welfare Dr Hitinder Kaur, Director ESI Dr Jaspreet Kaur, Director Principal AIMS Mohali Dr Bhavneet Bharti, Dr Bhupinder Singh, Professor & Head, Cardiology, AIIMS Bathinda; Dr Parminder Singh Manghera, Assistant Professor, Cardiology, GMC Amritsar; Dr Saurabh Sharma, Assistant Professor, Cardiology, GMC Patiala, Assistant Director cum State Program Officer NP-NCD Dr Gagandeep Singh Grover and Medical Officer Dr Ashu were also present on the occasion.
BOX: What is a STEMI?
An ST-elevation myocardial infarction (STEMI) is a type of heart attack that is more serious and has a greater risk of serious complications and death. An infarction is a blockage of blood flow to the myocardium, the heart muscle. That blockage causes the heart muscle to die. Therefore restoring blood flow quickly may keep the damage from being permanent or at least minimize the severity of the damage.
Utilising a Hub and Spoke Model, the project connects district health facilities with tertiary care hospitals to facilitate timely diagnosis, expert consultation via tele-ECG, and immediate administration of free thrombolytic therapy, followed by transfer for advanced care.