Recently, representatives from the Cleveland Clinic visited Indian experts for a knowledge exchange. Raelene Kambli catches up Dr Umesh Khot, Vice Chairman, Department of Cardiovascular Medicine, COO, Section of Clinical Cardiology, Cleveland Clinic, to understand his perspective on the opportunities and threats in cardiac science for India
Excerpt….
Brief us about the global Cardiovascular disease (CVD) burden.
The CVD epidemic started off in the US and Europe in the 1950s which started to slow down with the availability of better treatment but the explosion has shifted to lower and middle income countries in particular, India. The highest risk of heart disease in the world rests with the Indian population. We are seeing an explosion of heart diseases both heart attacks and heart failures and the most dramatic things is that it happens at a very young age. The average age of heart disease in India is almost 10-20 years younger than the people in the US.
Indians are genetically predisposed to heart disease. Can you explain this further?
This is not completely well understood. Indians are very sensitive to smaller weight gains than an American population. So if an Indian would gain around 10 kg of weight, that person would suddenly become diabetic as compared to a caucasian population. There are a lot of theories surrounding this subject and scientists are still researching on the genetic connection of heart diseases among Indians.
What is your opinion on heart transplants?
It is nice to have the technology and facility to have heart transplants but in my opinion I feel that patients should not reach that level that they require a transplant. We need to look at preventing heart attacks.
So, what are the opportunities and threats for cardiac sciences in India?
The scenario has changed in India in the last 10-15 years with the availability of technology. This opens up a lot of opportunities for cardiac sciences. The biggest challenge that India faces is the delivery of care. India has the expertise and the technology but delivering that care at the right time to the patients is a huge challenge and this is something that we need to work upon.
How can we turn these challenges into opportunities?
Well, that is why I am here. I work with this group called StemiIndia, which stands for ST Elevation Myocardial Infarction (STEMI). We have worked together to design a heart attack system for India.This system is designed specifically for India as the situation is quiet different here as compared to the US. Here, we use a combination of thrombolysis drug with a heart catherisation to treat heart attacks and the treatment is accessible even in the rural areas. We have started this initiative in the state of Tamil Nadu and its success story has been published in an American journal which shows how they have reduced the death rate using this technique.
Which technologies can be leveraged to improve cardiac sciences in India?
One nice thing about India is that, the country is focusing on information technology and is leveraging the digital space very well. People in India love their smart phones and are utilising it to the best use. Even doctors in India are utilising smart phone technology much faster than us. Therefore they have more advantage in several areas. This will take India ahead of other countries especially in terms of mobile technology and transmission.
Infact, I came on the whatsapp platform because of my counter parts in India. Things don’t function here without it and in one way it build communities and drives faster communication. So, you see that’s the advantage and influence these technologies can have.
So are you involved in helping Indian doctors to conduct research in cardiac sciences?
Yes, we have done a research on the heart attack system for India and published it in the Indian Heart Journal where we wrote about how to design a heart attack system for India. And over the last five years, we have taken that message across the country. We started with Chennai, Bengaluru, Mumbai and Hyderabad. This year we went to Vijaywada and next year we will be going to the north.
What is Cleveland Clinic’s vision for collaborating with India?
Cleveland Clinic has a long stand international perspective and because India’s healthcare system has grown so much, we wish to partner with Indian physicians by providing them training, exchange knowledge. We would also like to partner with the governments in many ways.
What is your message to the cardiac science fraternity in India?
There is a need for organisation of cardiac care across the country. The Indian healthcare providers need to connect the dots and how care can be provided to every patient at the right time and at an affordable cost.