Management of Acute ST Segment Elevation Myocardial Infarction (STEMI) 2019

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-PCIcapable 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 Bin Abdullah
Director-General of Health Malaysia
Ministry of Health Malaysia


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.


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