Abdelhamid Moustaghfir1, Mohand Haddak, Rachid Mechmeche. 1. Service des soins intensifs et rythmologie, faculté de médecine de Rabat, hôpital militaire d'instruction Mohammed V, Rabat, Morocco. moustaghfir64@gmail.com
Abstract
BACKGROUND: The burden of cardiovascular diseases is anticipated to rise in developing countries. We sought to describe the epidemiology, management, and clinical outcomes of patients hospitalized with acute coronary syndromes (ACS) in three countries in western North Africa. METHODS: Adult patients hospitalized with a diagnosis of ACS were enrolled in the prospective ACute Coronary Events - a multinational Survey of current management Strategies (ACCESS) registry over a 13-month period (January 2007 to January 2008). We report on patients enrolled at sites in Algeria, Morocco and Tunisia. A standardized form was used to collect data on patient characteristics, treatments and outcomes. RESULTS: A total of 1687 patients with confirmed ACS were enrolled (median age 59 [interquartile range 52, 68] years; 76% men), 59% with ST-elevation myocardial infarction (STEMI) and 41% with non-ST-elevation ACS (NSTE-ACS). During hospitalization, most patients received aspirin (96%) and a statin (90%), 83% received a beta-blocker and 74% an angiotensin-converting enzyme inhibitor. Among eligible STEMI patients, 42% (419/989) did not receive fibrinolysis or undergo percutaneous coronary intervention. All-cause death at 12 months was 8.1% and did not differ significantly between patients with STEMI or NSTE-ACS (8.3% vs 7.7%, respectively; Log-rank test P=0.82). Clinical factors associated with higher risk of death at 12 months included cardiac arrest, cardiogenic shock, bleeding episodes and diabetes, while percutaneous coronary intervention and male sex were associated with lower risk. CONCLUSIONS: In this observational study of ACS patients from three Maghreb countries, the use of evidence-based pharmacological therapies for ACS was quite high; however, 42% of the patients with STEMI were not given any form of reperfusion therapy.
BACKGROUND: The burden of cardiovascular diseases is anticipated to rise in developing countries. We sought to describe the epidemiology, management, and clinical outcomes of patients hospitalized with acute coronary syndromes (ACS) in three countries in western North Africa. METHODS: Adult patients hospitalized with a diagnosis of ACS were enrolled in the prospective ACute Coronary Events - a multinational Survey of current management Strategies (ACCESS) registry over a 13-month period (January 2007 to January 2008). We report on patients enrolled at sites in Algeria, Morocco and Tunisia. A standardized form was used to collect data on patient characteristics, treatments and outcomes. RESULTS: A total of 1687 patients with confirmed ACS were enrolled (median age 59 [interquartile range 52, 68] years; 76% men), 59% with ST-elevation myocardial infarction (STEMI) and 41% with non-ST-elevation ACS (NSTE-ACS). During hospitalization, most patients received aspirin (96%) and a statin (90%), 83% received a beta-blocker and 74% an angiotensin-converting enzyme inhibitor. Among eligible STEMI patients, 42% (419/989) did not receive fibrinolysis or undergo percutaneous coronary intervention. All-cause death at 12 months was 8.1% and did not differ significantly between patients with STEMI or NSTE-ACS (8.3% vs 7.7%, respectively; Log-rank test P=0.82). Clinical factors associated with higher risk of death at 12 months included cardiac arrest, cardiogenic shock, bleeding episodes and diabetes, while percutaneous coronary intervention and male sex were associated with lower risk. CONCLUSIONS: In this observational study of ACS patients from three Maghreb countries, the use of evidence-based pharmacological therapies for ACS was quite high; however, 42% of the patients with STEMI were not given any form of reperfusion therapy.
Authors: Marwah Abdalla; Neal Kovach; Connie Liu; Julie B Damp; Eiman Jahangir; Anthony Hilliard; Rakesh Gopinathannair; Mazen S Abu-Fadel; Mikhael F El Chami; Sameer Gafoor; Rajesh Vedanthan; Monica Sanchez-Shields; Jon C George; Tiffany Priester; Mirvat Alasnag; Colin Barker; Andrew M Freeman Journal: J Am Coll Cardiol Date: 2016-01-04 Impact factor: 24.094
Authors: Faouzi Addad; Abdallah Mahdhaoui; Jeridi Gouider; Essia Boughzela; Samir Kamoun; Mohamed Rachid Boujnah; Habib Haouala; Habib Gamra; Faouzi Maatouk; Ali Ben Khalfallah; Salem Kachboura; Hedi Baccar; Nejeh Ben Halima; Ali Guesmi; Khaled Sayahi; Wissem Sdiri; Ali Neji; Ahmed Bouakez; Sami Milouchi; Kais Battikh; Yves Jullieres; Nicolas Danchin; Jean Jacques Monsuez; Genevieve Mulak; Albert Hagege; Vincent Bataille; Rafik Chettaoui; Mohamed Sami Mourali Journal: PLoS One Date: 2019-02-22 Impact factor: 3.240
Authors: Khalid F Alhabib; Habib Gamra; Wael Almahmeed; Ayman Hammoudeh; Salim Benkheddah; Mohammad Al Jarallah; Ahmed Al-Motarreb; Mothanna Alquraishi; Mohamed Sobhy; Magdi G Yousif; Fahad Alkindi; Nadia Fellat; Mohammad I Amin; Muhammad Ali; Ayman Al Saleh; Anhar Ullah; Faiez Zannad Journal: PLoS One Date: 2020-07-22 Impact factor: 3.240