Abstract
Background: The burden of cardiovascular diseases is predicted to escalate in developing countries. We investigated the descriptive epidemiology, practice patterns, and outcomes of patients hospitalized with acute coronary syndromes (ACS) in African, Latin American, and Middle Eastern countries. Methods: In this prospective observational registry, 12,068 adults hospitalized with a diagnosis of ACS were enrolled between January 2007 and January 2008 at 134 sites in 19 countries in Africa, Latin America, and the Middle East. Data on patient characteristics, treatment, and outcomes were collected. Results: A total of 11,731 patients with confirmed ACS were enrolled (46% with ST-elevation myocardial infarction [STEMI], 54% with non-ST elevation-ACS). During hospitalization, most patients received aspirin (93%) and a lipid-lowering medication (94%), 78% received a β-blocker, and 68% received an angiotensin-converting enzyme inhibitor. Among patients with STEMI, 39% did not receive fibrinolysis or undergo percutaneous coronary intervention. All-cause death at 12 months was 7.3% and was higher in patients with STEMI versus non-ST elevation-ACS (8.4% vs 6.3%, P <.0001). Clinical factors associated with higher risk of death at 12 months included cardiac arrest, antithrombin treatment, cardiogenic shock, and age >70 years. Conclusions: In this observational study of patients with ACS, the use of evidence-based pharmacologic therapies for ACS was quite high, yet 39% of eligible patients with STEMI received no reperfusion therapy. These findings suggest opportunities to further reduce the risk of long-term ischemic events in patients with ACS in developing countries.
| Original language | English |
|---|---|
| Pages (from-to) | 859.e22 |
| Journal | American Heart Journal |
| Volume | 162 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 2011 |
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In: American Heart Journal, Vol. 162, No. 5, 11.2011, p. 859.e22.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Management of acute coronary syndromes in developing countries
T2 - ACute Coronary Events-a multinational Survey of current management Strategies
AU - Bazzino, Oscar
AU - Monaco, Rolando
AU - Mario, Boskis
AU - Sergio, Chekherdemian
AU - Valeria, Curotto Maria
AU - Sergio, Eibar
AU - Ricardo, Esper
AU - Juan, Gagliardi
AU - Ernesto, Jacobo
AU - Carlos, Karmazyn
AU - Roberto, Martingano
AU - Sebastian, Nani
AU - Carlos, Poy
AU - Pablo, Spada
AU - Nicolau, Jose C.
AU - Neto, Abrahão Afiune
AU - Vale, Andréia Assis Loures
AU - Chagas, Antonio Carlos Palandre
AU - Bozza, Augusto Elias Zaffalon
AU - Garbelini, Benito
AU - Scherr, Carlos
AU - Costantini, Costantino Roberto Frack
AU - de Abreu, Emmanuel
AU - Manenti, Euler R.F.
AU - Ribeiro, Expedito E.
AU - Reis, Gilmar
AU - Greque, Gilmar Valdir
AU - Xavier, Hermes Toros
AU - Mangione, José Armando
AU - Ribeiro, José Marcio
AU - Piegas, Leopoldo Soares
AU - Bodanese, Luiz Carlos
AU - Tanajura, Luiz Fernando
AU - Teixeira, Marcelo Silveira
AU - Pavanello, Ricardo
AU - Cunha, Roberto Sá
AU - Santos, Silvio
AU - Escobar, Alvaro
AU - Salazar, Dora
AU - Cuenca, Gina
AU - Posada, Jose A.
AU - Navarrete, Solon
AU - Perez, Cesar
AU - Rolong, Balkis
AU - Cano, Nelson
AU - Lozano, Abner
AU - Lopez, Patricio
AU - Niño, Fedrico
AU - Herrera, Marlon
AU - Velandia, Julio
AU - Arango, Juan Carlos
AU - Isaza, Daniel
AU - Rey, Alejandro
AU - Castro, Luis Fernando
AU - Carvajal, Martin
AU - Gomez, Efrain
AU - Rago, Gino
AU - Hernandez, Hector Julio
AU - Ramirez, Wilson
AU - Valdez, Ingrid
AU - Nunez, Rafael
AU - Mejia, Nepomuceno
AU - Hernandez, David
AU - Tejada, Bolivar
AU - Lopez Luciano, Jose Rafael
AU - Javierre, Wilson
AU - Noyer, Nelson Baez
AU - Urena, Pedro
AU - Rodriguez, Pedro
AU - Guillen, Rafael
AU - Gonzalez, Herman
AU - Almonte, Maribel
AU - De Los Santos, Manuel
AU - Gonzalez, Ricardo Ivan
AU - Alvarez, Ernesto Diaz
AU - Pimentel, Fausto Ariel
AU - De Los Santos, Cesarina
AU - Warden, Fausto
AU - Gonzalez, Juan Carlos
AU - Novas, Luis Ney
AU - Vargas, Jose Aristides
AU - Almonte, Claudia
AU - Lopez, Persio
AU - Cuevas, Rolando
AU - Mármol, Ricardo
AU - Mesías, Manuel
AU - Escobar, Marco
AU - Guzmán, Edwin
AU - Pezo, Luis
AU - García, Santiago
AU - Vernaza, Jaime
AU - Chacón, Carlos
AU - Padilla, Tania
AU - Ochoa, Marcelo
AU - Vazquéz, Javier
AU - Domínguez, Santiago
AU - Molina, Juan Pablo
AU - Sánchéz, Mayra
AU - Guzman, Ismael
AU - Rodas, Marco Antonio
AU - Corona, Vinicio
AU - Sanchez, Carlos
AU - Rodas, Anibal
AU - Escaler, Bruno
AU - Wyss, Fernando
AU - Montenegro, Pablo
AU - Martínez-Sanchez, Carlos
AU - Aranguren, Fernando Petersen
AU - Oreandain, Victor
AU - Medina, Isaac
AU - Gaxiola López, Efraín
AU - Amarillas, Adrían Medina
AU - Calvillo, Jorge Carillo
AU - Leiva Pons, Jose Luis
AU - Sánchez, Jesús Martinez
AU - Meany, Eduardo
AU - Gutierrez, Armando Castro
AU - Santamaria, Ismael Hernandez
AU - Buenfil, José Carlos
AU - Chon, Octavio González
AU - Velasco, Gustavo Rojas
AU - Arias, Alexandra
AU - Zepeda, Cesar Acevedo
AU - Anaya, Antonio Carrillo
AU - Molina, Francisco Javier Valadez
AU - Azpiri, José Ramón
AU - Chazaro, Enrique Ramos
AU - Alva, Juan Carlos Pérez
AU - Argüelles, Victor Armando Varguez
AU - Reyes, Abraham Galicia
AU - Pérez, Mauricio Zaragoza
AU - Gómez, Raul Mendoza
AU - Aldaco, Salvador Nieto
AU - Gil, Jorge Alvarez
AU - Ortiz, Roberto Betancourt
AU - Romero, Sergio González
AU - Favela, Raúl Armando Martinez
AU - Medina, Mario Humberto Morales
AU - Moscoso, Jorge Alberto
AU - Ruvalcaba, Juan Carlos Ramírez
AU - Montes, Eliodoro Castro
AU - González, Salvador León
AU - Pacheco, Nancy
AU - Bello, Miguel Angel Méndez
AU - Gamba, Marco Antonio Alcocer
AU - Escalante, Francisco Javier Redding
AU - Otero, Orlando Henne
AU - Martinez, Francisco Javier Guerrero
AU - Reding, Jesús Martínez
AU - Gamez, Miguel Beltran
AU - Ana, Marcos Robledo Santa
AU - Esperon, Guillermo Llamas
AU - Sedano, Jesús Zuñiga
AU - Díaz, Carlos Jerjes Sánchez
AU - Bustillos, Manuel Barrera
AU - Zacarías, Jose Luis
AU - Padilla, Javier Orduña
AU - de la Cadena Sillas, Jorge Alvarez
AU - Hernández, Enrique García
AU - De León Orfaly, María Cruz
AU - Correa, Ricardo Martínez
AU - de Jesús Bermúdez Aceves, Erick
AU - Álvarez, Enrique Gómez
AU - Ruiz, Julio Iván Farjat
AU - Briones, Ignacio Rodriguez
AU - de Jesús Rivera Arellano, José
AU - López Quijano, Juan Manuel
AU - Pedrero, Javier Gonzalez
AU - Ortega, Oscar Mendoza
AU - Espinoza, Hector Soto
AU - Flores, Alejandro
AU - Rodríguez, Rosa Elena Limas
AU - Martínez, Guillermo Rivera
AU - Luna, Jorge
AU - Armando, Loera Pinales
AU - Ortiz, Samuel Varela
AU - Muciño, Alberto Zamora
AU - Martinez Resendíz, Jose Antonio
AU - Contreras, Paul Vázquez
AU - Arasi, Jose Luis Guadarrama
AU - Gutierrez, Javier Marín
AU - Matadamas, Norberto
AU - Saldaña, Arturo
AU - Eduardo, Rivera Quintero
AU - Madrid y Basurto, Jorge
AU - San Gabriel, Amanda Alvarez
AU - Castillo, Alfredo Altamirano
AU - Villegas, Juan Moleres
AU - Padilla, Sergio Salas
AU - Comparan, Alfredo
AU - Ricoy, Guillermo Naranjo
AU - Guerrero, Humberto
AU - Castro, Javier Antezana
AU - Suárez, Alfredo Estrada
AU - Montaño, Luis Rodolfo Flores
AU - Medina, Ignacio Arroniz
AU - Contreras, Miguel Antonio Guerra
AU - Ortega, Jaime Aldaco
AU - Ruiz, Jose Luis Hernandez
AU - Rodríguez, Rodolfo Gaona
AU - del Angel, Edgar Noel Sosa
AU - Bermea, Eduardo Martinez
AU - Antepara, Norka
AU - Garcia, Victor
AU - Mancebo, Jose Gomez
AU - Rosenthal, Jacobo
AU - Santucci, Giovanny
AU - Marulanda, Maria Ines
AU - Jimenez, Alvaro
AU - Sobhy, Mohamed
AU - Hamdy, Nagy
AU - Hamza, Mahmoud
AU - Riad, Youssef
AU - Matar, Magdy
AU - El Hossary, Hossam
AU - Rashwan, Magdy
AU - Al-Nagar, Wael
AU - El Tahan, Mamdouh
AU - El-Etriby, Adel
AU - Samir, Henry
AU - Galal, Wagdy
AU - Hegazy, Abdel Monaem
AU - El-Aasar, Hisham
AU - Taher, Mohamed Awad
AU - El-Rakshy, Yehia
AU - Ghareeb, Soliman
AU - Mahmoud, Kamal
AU - Louis, Samuel
AU - Gamal, Adel
AU - Saleh, Ayman
AU - Wafa, Samir
AU - Taha, Naser
AU - Rahman, Yasser Abdel
AU - Sanad, Osama
AU - Kabil, Hamza
AU - Hakim, Victor
AU - El Menshawy, Diaa
AU - Hamid, Magdy Abdel
AU - Mohamed, Amr Kamal
AU - Ghany, Mohammed Abdel
AU - Khalil, Tarek
AU - Zeidan, Aly
AU - Mandour, Mohammed
AU - Kandil, Hossam
AU - Riad, Ramzy
AU - El Sayed, Ayman
AU - Fatah, Aliaa Abdel
AU - Rahman, Ahmed Abdel
AU - Al-Aziz, Ahmad Abd
AU - Baghdady, Yasser
AU - Al Nasr, Gamal Abou
AU - Magdy, Ahmed
AU - Khashaba, Ahmed
AU - Sadek, Ikram
AU - Leon, Khaled
AU - Guindi, Ramez
AU - Ashmawy, Medhat
AU - Abdo, Manal
AU - El Badry, Mahmoud
AU - Gobran, Nabil
AU - Adham, Mostafa
AU - El-Mawardy, Ramzy
AU - Shaheen, Sameh
AU - Awad, Omar
AU - Reda, Ashraf
AU - Radwan, Farouk
AU - Mahfouz, Essam
AU - Fureur, Abdel Fattah
AU - Bakr, Helmy
AU - Davoodi, Gholamreza
AU - Maleki, Majid
AU - Bassiri, Hosseinali
AU - Pourmoghaddas, Masoud
AU - Khosravi, Alireza
AU - Kermanshahi, Tahereh Zandi
AU - Parpari, Saeid Haghighi
AU - Salehi, Negar
AU - Al-Saleh, Akram
AU - Badaieneh, Yahaya
AU - Emash, Abdallah
AU - Farasek, Naiazi Abu
AU - Saadh, Abdallah
AU - Bustami, Basem
AU - Mofleh, Ibrahim
AU - Hantash, Hadi Abu
AU - Al Kadri, Nazeh
AU - Al Nimri, Marwan
AU - Hroub, Sabri
AU - Hamoudeh, Aymin
AU - Sawalha, Walid
AU - Samaleh, Qasam
AU - Sedki, Mazen
AU - Jarad, Ibrahim
AU - Al Mousa, Iyas
AU - Qanna, Abdelqader
AU - Odeh, Eymin
AU - Baghal, Mohamed
AU - Farah, Hidar
AU - Namas, Assem
AU - Al Kaka, Zakaria
AU - Abbadi, Hatem
AU - Tabalat, Ramzi
AU - Zubaid, Mohammad
AU - Rashed, Wafa
AU - Saad, Hisham
AU - Attiya, Ali
AU - Bahnasy, Yaser
AU - Abdulminam, Amru
AU - Al Mahmeed, Wael
AU - Zubaidi, Abdulmajid
AU - Bakir, Sherif
AU - Al Bustani, Naza
AU - Jabbari, Samir
AU - Sousi, Awatif
AU - Agrawal, Amrish
AU - Kunju, Aboobaker
AU - Binbrek, Azan
AU - Gabroun, Ahmed
AU - Ali, Yousof
AU - Bazargani, Nooshin
AU - Ghanaim, Mohammed Mahmoud
AU - Ali, Sadiq
AU - Wasif, Adel Abdullah
AU - Alam, Samir
AU - Sater, Ludmilla Abdel
AU - Adhami, Atika
AU - Al Chall, Saleh
AU - Rammal, Ahmad
AU - Feghali, Nassif
AU - Keshishian, Sahak
AU - Arnaout, Samir
AU - Atab, Suheil
AU - Awad, Mohamad
AU - Badawi, Georges
AU - Rahal, Malek
AU - Cherri, Sami
AU - Dada, Sobhi
AU - Hajj, Antoine
AU - Daou, Abdo
AU - Dergham, Sayed
AU - Dib, Hicham
AU - Najm, Youssef
AU - El Bayegh, Hamid
AU - Mokdad, Sleiman
AU - Fadel, Ali
AU - Farhat, Ali
AU - Ghanem, Georges
AU - Hachem, Ezzat
AU - Hamade, Ismail
AU - Hobeika, Robert
AU - Ibrahim, Toni
AU - Ismail, Mohamad
AU - Jazra, Charles
AU - Kaady, Jean
AU - Kaddoura, Hicham
AU - Hemadeh, Malek
AU - Karam, Carma
AU - Bizri, Hilal
AU - Khoury, Rene
AU - Klait, Mohamad
AU - Kuwaise, Ali
AU - Sarkis, Antoine
AU - Mdayhli, Abbas
AU - Mohamad, Malek
AU - Morad, Kamal
AU - Mouawad, Walid
AU - Mansour, Mohamad
AU - Ghandour, Hassan
AU - Skakini, Adel
AU - Timani, Nadim
AU - Yazbek, Naji
AU - Mroueh, Ghassan
AU - Hammoud, Ahmad
AU - Hammouda, Ashraf
AU - Alturki, Fawaz
AU - Alwedaa, Hassan
AU - Al Amry, Hussen
AU - Al Otabi, Mohamed
AU - El Nemr, Khalid
AU - El Motari, Khalid
AU - Abdeen, Gamal
AU - Al Ghobaish, Abdullah
AU - Al Bustanji, Haidar
AU - Moselhy, Mohamed Saleh
AU - Eldardery, Diaa
AU - Ahmad, Waqar
AU - Elshibi, Khaled
AU - Khoder, Waleed Abu
AU - Elmahdy, Naser
AU - Eltarabeni, Ameer
AU - Tawfiq, Mohamed
AU - Al-Mashari, Hessah
AU - Khalil, Khalil Mohamed
AU - Hameed, Asef
AU - Yousef, Mustafa Adel
AU - Al Kordy, Mohamed
AU - Hegazy, Hesham
AU - Kharafany, Mohammed
AU - El-Bendary, Sameh
AU - El-Aayan, Alaa
AU - Shehab, Yasser
AU - Shatoor, Abdullah
AU - Asseery, Abdulllah
AU - El-Gouzi, Ali
AU - Khaleefa, Merghany
AU - El-Harby, Ibrahim
AU - El-Ashgar, Eman
AU - Malek, Assef
AU - Mitwaly, Othman
AU - El-Harch, Mekael
AU - Hourany, Nabeel
AU - Fakeeh, Bassam
AU - El-Sayed, Hassan
AU - Basher, Yasser
AU - Jameel, Magdi
AU - Yassen, Abdulrahman
AU - Haddak, Mohand
AU - Bendaoud, Nabil
AU - Saidane, Mourad
AU - Latreche, Samia
AU - Aoudia, Yazid
AU - Ramdani, Hocine
AU - Ahnia, Samir
AU - Ghemri, Sofiane
AU - Chaouche, Mourad Chabane
AU - Lehachi, Saliha
AU - Kachnoura, Aldjia
AU - Messaad, Krim
AU - Hammidouche, Karima
AU - Cherif, Abdelghani Bachir
AU - Rahli, Aziz
AU - Beddai, Mohamed Fayçal
AU - Manamani, Lila
AU - Meziane, Tarek
AU - Kara, Zakia Mostefa
AU - Benyoucef, Nassima
AU - Ellah, Daim
AU - Moustaghfir, Abdelhamid
AU - Darif, Abdellatif
AU - Louali, Abdou
AU - Allaoui,
AU - Bennis, Ahmed
AU - Azzouzi, Laila
AU - Saadaoui, Mohamed
AU - Habbal, Rachida
AU - Abdelkhirane, Cherif
AU - Fihri, Oussama Fassi
AU - Allali, Youssef
AU - Dahreddine, Abdessamad
AU - Hamani, Ahmed
AU - Ztot, Samir
AU - Chaara, Assad
AU - Bahosse, Saadia
AU - Khatouri, Ali
AU - Faik, Ridwane
AU - El Fath, Samira
AU - Bel Aouchi, Faycal
AU - Riad, Naima
AU - Oudghiri, Saïd
AU - Nazzi, M'Barek
AU - Akoudad, Hafid
AU - Tarhbalouti, Rachid
AU - Chbil, Mohamed
AU - Boubel, Kenza
AU - Elkhatib, Said
AU - Mechmech, Rachid
AU - Rachid, Boujnah
AU - Abdeljlil, Farhati
AU - Essia, Boughzela
AU - Faouzi, Addad
AU - Ali, Ben Khalfallah
AU - Mohamed, Ben Farhat
AU - Salem, Kachboura
AU - Samir, Kammoun
AU - Jeridi, Gouider
AU - Iheb, Chahbani
AU - Traki, Karaborni
AU - Nabil, Marsit
AU - Kammoun, Hilmi
AU - Hassine, Ridha
AU - Schamroth, Colin
AU - Corbett, Clive
AU - Krausey, Matthew
AU - Ignjatovic, Goran
AU - Kettles, David
AU - Theron, Hennie
AU - Steyn, Cobus
AU - Barnard, Braam
AU - Ebrahim, Iftikhar
AU - Zeelie, Roland
AU - Singh, Victor
AU - Mutati, Pule
AU - Da Silva, Agostinho
AU - Venter, Tjaart
AU - Kapp, Ilse
AU - Blomerus, Pieter
AU - Cassel, Graham
AU - Dalby, Anthony
AU - Deseta, Juan
AU - Patel, Nalin
AU - Van Der Merwe, Nico
AU - Tayob, Fazul
AU - Letcher, Guy
AU - Middlemost, Shirley
AU - Essop, Mohammed
AU - Nunkoon, Theema
AU - Pappachan, A.
AU - Becker, Anthony
AU - Bera, Yasmin
AU - Zambakides, Christos
AU - Steingo, Leonard
AU - Benjamin, John
AU - Commerford, Patrick
AU - King, Jeffrey
AU - Khan, Sajidah
AU - Snyders, Adriaan
AU - Khan, Mohamed
N1 - Publisher Copyright: © 2011 Mosby, Inc. All rights reserved.
PY - 2011/11
Y1 - 2011/11
N2 - Background: The burden of cardiovascular diseases is predicted to escalate in developing countries. We investigated the descriptive epidemiology, practice patterns, and outcomes of patients hospitalized with acute coronary syndromes (ACS) in African, Latin American, and Middle Eastern countries. Methods: In this prospective observational registry, 12,068 adults hospitalized with a diagnosis of ACS were enrolled between January 2007 and January 2008 at 134 sites in 19 countries in Africa, Latin America, and the Middle East. Data on patient characteristics, treatment, and outcomes were collected. Results: A total of 11,731 patients with confirmed ACS were enrolled (46% with ST-elevation myocardial infarction [STEMI], 54% with non-ST elevation-ACS). During hospitalization, most patients received aspirin (93%) and a lipid-lowering medication (94%), 78% received a β-blocker, and 68% received an angiotensin-converting enzyme inhibitor. Among patients with STEMI, 39% did not receive fibrinolysis or undergo percutaneous coronary intervention. All-cause death at 12 months was 7.3% and was higher in patients with STEMI versus non-ST elevation-ACS (8.4% vs 6.3%, P <.0001). Clinical factors associated with higher risk of death at 12 months included cardiac arrest, antithrombin treatment, cardiogenic shock, and age >70 years. Conclusions: In this observational study of patients with ACS, the use of evidence-based pharmacologic therapies for ACS was quite high, yet 39% of eligible patients with STEMI received no reperfusion therapy. These findings suggest opportunities to further reduce the risk of long-term ischemic events in patients with ACS in developing countries.
AB - Background: The burden of cardiovascular diseases is predicted to escalate in developing countries. We investigated the descriptive epidemiology, practice patterns, and outcomes of patients hospitalized with acute coronary syndromes (ACS) in African, Latin American, and Middle Eastern countries. Methods: In this prospective observational registry, 12,068 adults hospitalized with a diagnosis of ACS were enrolled between January 2007 and January 2008 at 134 sites in 19 countries in Africa, Latin America, and the Middle East. Data on patient characteristics, treatment, and outcomes were collected. Results: A total of 11,731 patients with confirmed ACS were enrolled (46% with ST-elevation myocardial infarction [STEMI], 54% with non-ST elevation-ACS). During hospitalization, most patients received aspirin (93%) and a lipid-lowering medication (94%), 78% received a β-blocker, and 68% received an angiotensin-converting enzyme inhibitor. Among patients with STEMI, 39% did not receive fibrinolysis or undergo percutaneous coronary intervention. All-cause death at 12 months was 7.3% and was higher in patients with STEMI versus non-ST elevation-ACS (8.4% vs 6.3%, P <.0001). Clinical factors associated with higher risk of death at 12 months included cardiac arrest, antithrombin treatment, cardiogenic shock, and age >70 years. Conclusions: In this observational study of patients with ACS, the use of evidence-based pharmacologic therapies for ACS was quite high, yet 39% of eligible patients with STEMI received no reperfusion therapy. These findings suggest opportunities to further reduce the risk of long-term ischemic events in patients with ACS in developing countries.
UR - https://www.scopus.com/pages/publications/81255214737
U2 - 10.1016/j.ahj.2011.07.029
DO - 10.1016/j.ahj.2011.07.029
M3 - Article
C2 - 22093201
AN - SCOPUS:81255214737
SN - 0002-8703
VL - 162
SP - 859.e22
JO - American Heart Journal
JF - American Heart Journal
IS - 5
ER -