「Wholeheartedness. Love. Cardiac care. Heart protection. Sincerity」

It is an honour to receive the support of experts and assume the association's responsibilities, allowing me to contribute to improving myocardial infarction education and care quality in Taiwan. This is a challenging task, as cardiovascular diseases have long ranked among the country's top two causes of death, with myocardial infarction mortality rates remaining persistently high. Effective myocardial infarction care requires dedicated interdisciplinary collaboration. Therefore, our association has invited experts in public health, fire safety, cardiology, emergency medicine, smoking cessation, nursing, cardiac surgery, rehabilitation, heart transplantation, radiology, catheterization techniques, palliative care, critical care, and interventional therapy to join us. Through the collaboration and educational models established by these different experts, we aim to build a comprehensive myocardial infarction care network.

Myocardial infarction is a multi-dimensional care disease involving public education, prevention of myocardial infarction, ambulance transfers, pre-hospital pharmacological treatment, urgent cardiac catheterization upon arrival, post-arrival medication treatment, post-arrival rehabilitation, smoking cessation, nutritional education, and long-term follow-up for secondary prevention of recurrent myocardial infarction. Among these, public awareness serves as the first line of prevention. A general understanding of the ever-changing nature of myocardial infarction, especially among young individuals, remains a concern. As stated in the "Qianjin Yaofang Lun Zhenhou Di Si" (Essential Prescriptions Worth a Thousand Gold, Chapter Four), "The ancient physicians excel in treating the illness before it arises." In the future, we hope to promote public awareness with compassion, early treatment and prevention of myocardial infarction for individuals at risk, such as those with hypertension, hyperlipidemia, diabetes, and smoking habits. This includes early treatment and smoking cessation to prevent the occurrence of myocardial infarction.

Myocardial infarction is a race against time, and the timeliness of rescue before and after arrival at the hospital is critical. It involves educating and raising awareness among the public, paramedics, emergency physicians, nurses, cardiologists, and intensivists. The way individuals seek medical care may impact their prognosis. Four critical factors for ambulance transportation and medical care include well-trained paramedics with CPR skills, the availability of automated external defibrillators (AEDs) in ambulances, the use of mobile transmission pre-hospital electrocardiogram systems in ambulances, and the ability to complete electrocardiograms at the emergency scene for timely diagnosis, mobilization of hospitals, and prompt, safe treatment for patients. Furthermore, the early use of antiplatelet medications on ambulances is crucial. However, according to data from Kaohsiung City, only about 20% of individuals with myocardial infarction use ambulance services. Therefore, public education is vital. The life-saving mantra "Chest pain, shortness of breath, cold sweats, call for an ambulance" should be emphasized. When individuals experience symptoms such as chest pain, tightness, shortness of breath, and cold sweats, which may indicate a high likelihood of myocardial infarction, it is recommended to immediately dial 119 for an ambulance.

After arrival at the hospital, initiating emergency cardiac catheterization to reduce the time to vessel reperfusion is essential for further rescuing the patient's heartbeat. Therefore, prompt mobilization in the emergency department, rapid diagnosis, timely medication administration, and the convenient management of complex lesions, shock, or cardiac arrest by the catheterization team are crucial steps in cardiac rescue.

Reopening the occluded blood vessel does not indicate the completion of treatment. Continuous care in the subsequent phases is crucial to prevent secondary cardiac injuries. The intensive care team provides ongoing care for patients in shock or cardiac arrest and appropriate medication for myocardial infarction, including antiplatelet drugs, novel oral anticoagulants (NOACs), angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), beta-blockers, angiotensin receptor-neprilysin inhibitors (ARNIs), glucagon-like peptide 1 receptor agonists or analogues (GLP-1 receptor agonists or analogues), soluble guanylate cyclase stimulators (sGC stimulators), and sodium-glucose transporter 2 inhibitors (SGLT2 inhibitors), can improve patient outcomes. Medical technologies such as extracorporeal membrane oxygenation (ECMO), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) can change the fate of patients when appropriately applied. Nutrition, rehabilitation, smoking cessation, and other treatments are integral to recovery.

Myocardial infarction treatment is continuously evolving, and in the era of artificial intelligence and the COVID-19 pandemic, we will assist the Ministry of Health and Welfare's Department of Medical Affairs in promoting the "Emergency Medical Rescue Intelligent Platform - One-Stop Emergency and Rescue Promotion Plan." Furthermore, we will actively promote the development of a smart city for myocardial infarction care and update relevant disease treatment consensus or guidelines based on the latest evidence. The association also actively invites young experts to join various committees, enabling sustainable development in myocardial infarction care in Taiwan. To enhance the quality of myocardial infarction care in Taiwan, we will initiate the Taiwan Acute Coronary Syndrome Registry (TACSR) and collaborate with hospitals nationwide to establish a registration system. This will further facilitate the international dissemination of Taiwan's care achievements. Additionally, we will cooperate with relevant organizations and the international myocardial infarction community of EuroPCR Stent Save a Life to assist other countries in advancing myocardial infarction care and save the world's heartbeat together.

TAiwan Myocardial Infarction Society

Honorary Chairman Wei-Chun Huang