“…The Trivandrum Heart Failure registry has identified that, among patients with heart failure with reduced left ventricular ejection fraction, guideline-based therapy was given to only 19% on hospital admission and 25% at discharge. 5 The PINNACLE (Practice Innovation and Clinical Excellence) registry, a collaboration between the American College of Cardiology and Indian stakeholders, is an example of a quality improvement program at a national level to consider outpatient care of CVD. 6 In this issue of JAMA Cardiology, the results of the Tamil Nadu-ST-Segment Elevation Myocardial Infarction (TN-STEMI) program are presented, addressing the gap in research on acute CVD with longer-term follow-up in India.…”