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Summary Clinical practice guidelines for the management of ST elevation MI
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an in depth and comprehensive cpg for the management of STEMI
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MOH/P/PAK/420.19(GU)-eCLINICAL PRACTICE
GUIDELINE:
0 1 9
2 TION
DI
4t E MANAGEMENT OF
h
ACUTE ST SEGMENT
ELEVATION MYOCARDIAL
INFARCTION (STEMI)
NATIONAL HEART ASSOCIATION
OF MALAYSIA
, MANAGEMENT OF ACUTE ST
SEGMENT ELEVATION MYOCARDIAL
INFARCTION (STEMI) 2019
STATEMENT OF INTENT
This guideline was developed to be a guide for best clinical practice, based on the
best available evidence at the time of development. Specific attempts were made
to use local data and publications to ensure local relevance. Adherence to this
guideline does not necessarily lead to the best clinical outcome in individual patient
care. Every healthcare provider is responsible for the management of his/her unique
patient based on the clinical presentation and management options available locally.
REVIEW OF THE GUIDELINE
This guideline is issued in 2019 and will be reviewed in 2024 or earlier if important
new evidence becomes available.
CPG Secretariat
Health Technology Assessment Unit
Medical Development Division
Level 4, Block EI, Parcel E
Government Offices Complex
62590 Putrajaya, Malaysia
Available on the following websites:
http://www.moh.gov.my
http://www.acadmed.org.my
2
, MANAGEMENT OF ACUTE ST
SEGMENT ELEVATION MYOCARDIAL
INFARCTION (STEMI) 2019
MESSAGE FROM THE DIRECTOR GENERAL OF HEALTH
The 1st Clinical Practice Guideline (CPG) on ST Elevation Myocardial Infarction
(STEMI) was published in 2001 with a 2nd and 3rd update in 2007 and 2014
respectively. Rapid developments have taken place, especially in the area of
pre-hospital care. This 4th edition was developed to provide a clear and concise
approach based on current evidence with the focus being on efforts to reduce
the time from first medical contact, improve pre-hospital care as well support the
application of guideline-directed therapies.
This CPG has been prepared by a panel of committee members from the National
Heart Association of Malaysia (NHAM) and Ministry of Health (MOH). The committee
members were multidisciplinary and comprised of cardiologists, internal medicine,
family medicine, rehabilitation and emergency physicians from the government,
private sector and universities. Relevant clinical trial data and published literature
have been summarized and adapted to local practices. This guideline also
implemented the work of our very own national STEMI network which links non-PCI-
capable centres to PCI-capable centres so PCI services can be arranged in a timely
manner for all patients.
Ischaemic heart disease has been a significant burden to this country, and it
is projected that the burden will continue to increase with the rising number of
cardiovascular risk factors and an ageing population. I believe this CPG will be an
invaluable guiding document for healthcare providers involved in the management of
STEMI and subsequently be translated to an improved clinical outcome for patients
suffering from ischaemic heart disease.
DATUK DR NOOR HISHAM ABDULLAH
DIRECTOR GENERAL OF HEALTH OF MALAYSIA
3
, MANAGEMENT OF ACUTE ST
SEGMENT ELEVATION MYOCARDIAL
INFARCTION (STEMI) 2019
MEMBERS OF THE EXPERT PANEL
Chairperson:
Dr Jeyamalar Rajadurai
Consultant Cardiologist
Subang Jaya Medical Centre
Members:
(in alphabetical Order)
Dr Abdul Kahar Abdul Ghapar Dr Ong Mei Lin
Consultant Cardiologist, Consultant Cardiologist,
Head of Cardiology, Gleneagles Penang
Hospital Serdang
Dr Saari Mohamad Yatim
Dr Amin Ariff Nuruddin Consultant Rehabilitation Physician,
Consultant Cardiologist, Hospital Serdang
Head of Cardiology,
Institut Jantung Negara Dr Sabariah Faizah Jamaluddin
Consultant Emergency Physician,
Dr Ahmad Tajuddin Mohamad Nor
Hospital Sungai Buloh
Consultant Emergency Physician,
Hospital Tengku Ampuan Rahimah, Dr Wardati Mazlan Kepli
Klang, Selangor Clinical Pharmacist,
Hospital Serdang
Dr Gunavathy Muthusamy
Consultant Physician/Endocrinologist, Dr Wan Azman Wan Ahmad
Head of General Medicine, Consultant Cardiologist,
Hospital Shah Alam University Malaya Medical Centre
Dr Lee Kun Yun
Public Health Specialist,
Institute for Health Management,
Ministry of Health
Dr Narul Aida Salleh
Family Medicine Specialist,
Klinik Kesihatan Kuala Lumpur
4
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