Ischemic heart disease is the leading cause of mortality in the Philippines. Despite strong recommendations from clinical practice guidelines for reperfusion for acute myocardial infarction (AMI), local data reveal low rates of primary percutaneous coronary intervention (PCI) and early invasive strategies due to financial constraints and system inefficiencies. The recent expansion of the Philippine Health Insurance Corporation (PHIC) AMI benefits package presents an opportunity to improve access to appropriate care. A standardized, evidence-based national clinical pathway is needed to guide healthcare providers and ensure consistent, high-quality care of AMI across various healthcare settings.

To develop a standardized, evidence-based national clinical pathway for the management of AMI patients eligible under the PHIC IHD-AMI benefits package.

Existing AMI clinical pathways from nine public and private hospitals in the Philippines were collected and reviewed. A multidisciplinary Technical Working Group (TWG) appraised current guidelines using the AGREE II tool and evaluated the collected pathways to identify strengths, gaps and variations in practice. A draft pathway was created and refined through consensus-building with cardiology experts and stakeholders to develop the final pathway.

The final national AMI clinical pathway integrates evidence-based best practices and accounts for differences in institutional resources. It standardizes the use of ECG and cardiac biomarkers for diagnosis, provides clear criteria and timelines for reperfusion therapy, defines indications for coronary angiography and PCI, and recommends optimal medical therapy and cardiac rehabilitation.

The national AMI clinical pathway is a critical step toward improving the quality, equity and efficiency of AMI care in the Philippines. Developed through a collaborative, evidence-based process, it aligns clinical management with international standards while addressing local healthcare system realities. Adoption by PHIC as a quality standard is expected to enhance guideline adherence, inform health policy and financing, and drive improvements in health outcomes. Continued implementation support, monitoring and evaluation are necessary to ensure its impact, particularly in under-resourced or geographically isolated settings.