<h1>Cardiac care evolution: India emerging as a global innovator in precision-guided interventions and scalable medtech.</h1> The PRISM-PCI framework prioritizes precision-guided interventions-integrating imaging, physiology, advanced devices, and hybrid strategies-to manage growing procedural complexity. India's emergence as a developer of coronary stents, imaging-guided solutions, and transcatheter devices is identified as reducing import dependence and expanding access, contingent on strong clinical evidence, integrated platforms, and scalable manufacturing. Prevention and early detection are emphasized as necessary complements to interventions for sustained population health impact.