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Am Heart J. 2011 Nov;162(5):852-859.e22. doi: 10.1016/j.ahj.2011.07.029.

Management of acute coronary syndromes in developing countries: acute coronary events-a multinational survey of current management strategies.

Collaborators (517)

Bazzino O, Monaco R, Mario B, Sergio C, Valeria CM, Sergio E, Ricardo E, Juan G, Ernesto J, Carlos K, Roberto M, Sebastian N, Carlos P, Pablo S, Nicolau JC, Neto AA, Vale AA, Chagas AC, Bozza AE, Junior BG, Scherr C, Costantini CR, de Abreu E, Manenti ER, Ribeiro EE, Reis G, Greque GV, Xavier HT, Mangione JA, Ribeiro JM, Piegas LS, Bodanese LC, Tanajura LF, Teixeira MS, Pavanello R, Cunha RS, Santos S, Escobar A, Salazar D, Cuenca G, Posada JA, Navarrete S, Perez C, Rolong B, Cano N, Lozano A, Lopez P, Niño F, Herrera M, Velandia J, Arango JC, Isaza D, Rey A, Castro LF, Carvajal M, Gomez E, Rago G, Hernandez HJ, Ramirez W, Valdez I, Nunez R, Mejia N, Hernandez D, Tejada B, Luciano JR, Javierre W, Noyer NB, Urena P, Rodriguez P, Guillen R, Gonzalez H, Almonte M, De Los Santos M, Gonzalez RI, Alvarez ED, Pimentel FA, De Los Santos C, Warden F, Carlos Gonzalez J, Novas LN, Vargas JA, Almonte C, Lopez P, Cuevas R, Mármol R, Mesías M, Escobar M, Guzmán E, Pezo L, García S, Vernaza J, Chacón C, Padilla T, Ochoa M, Vazquéz J, Domínguez S, Molina JP, Sánchéz M, Guzman I, Rodas MA, Corona V, Sanchez C, Rodas A, Escaler B, Wyss F, Montenegro P, Martínez-Sanchez C, Aranguren FP, Oreandain V, Medina I, López EG, Amarillas AM, Calvillo JC, Pons JL, Sánchez JM, Meany E, Gutierrez AC, Santamaria IH, Buenfil JC, Chon OG, Velasco GR, Arias A, Zepeda CA, Anaya AC, Molina FJ, Azpiri JR, Chazaro ER, Alva JC, Argüelles VA, Reyes AG, Pérez MZ, Gómez RM, Aldaco SN, Gil JA, Ortiz RB, Romero SG, Favela RA, Medina MH, Moscoso JA, Ruvalcaba JC, Montes EC, González SL, Pacheco N, Bello MA, Gamba MA, Escalante FJ, Otero OH, Martinez FJ, Reding JM, Gamez MB, Santa Ana MR, Esperon GL, Sedano JZ, Díaz CJ, Bustillos MB, Zacarías JL, Padilla JO, Sillas JA, Hernández EG, Orfaly MC, Correa RM, Aceves Ede J, Álvarez EG, Ruiz JI, Briones IR, Arellano Jde J, Quijano JM, Pedrero JG, Ortega OM, Espinoza HS, Flores A, Rodríguez RE, Martínez GR, Luna J, Armando LP, Ortiz SV, Muciño AZ, Resendíz JA, Contreras PV, Arasi JL, Gutierrez JM, Matadamas N, Saldaña A, Eduardo RQ, Madrid y Basurto J, San Gabriel AA, Castillo AA, Villegas JM, Padilla SS, Comparan A, Ricoy GN, Guerrero H, Castro JA, Suárez AE, Montaño LR, Medina IA, Contreras MA, Ortega JA, Ruiz JL, Rodríguez RG, del Angel EN, Bermea EM, Antepara N, Garcia V, Mancebo JG, Rosenthal J, Santucci G, Marulanda MI, Jimenez A, Sobhy M, Hamdy N, Hamza M, Riad Y, Matar M, El Hossary H, Rashwan M, Al-Nagar W, El Tahan M, El-Etriby A, Samir H, Galal W, Hegazy AM, El-Aasar H, Taher MA, El-Rakshy Y, Ghareeb S, Mahmoud K, Louis S, Gamal A, Saleh A, Wafa S, Taha N, Rahman YA, Sanad O, Kabil H, Hakim V, El Menshawy D, Hamid MA, Mohamed AK, Ghany MA, Khalil T, Zeidan A, Mandour M, Kandil H, Riad R, El Sayed A, Fatah AA, Rahman AA, Al-Aziz AA, Baghdady Y, Al Nasr GA, Magdy A, Khashaba A, Sadek I, Leon K, Guindi R, Ashmawy M, Abdo M, El Badry M, Gobran N, Adham M, El-Mawardy R, Shaheen S, Awad O, Reda A, Radwan F, Mahfouz E, Fureur AF, Bakr H, Davoodi G, Maleki M, Bassiri H, Pourmoghaddas M, Khosravi A, Kermanshahi TZ, Parpari SH, Salehi N, Al-Saleh A, Badaieneh Y, Emash A, Farasek NA, Saadh A, Bustami B, Mofleh I, Hantash HA, Al Kadri N, Al Nimri M, Hroub S, Hamoudeh A, Sawalha W, Samaleh Q, Sedki M, Jarad I, Al Mousa I, Qann a A, Odeh E, Baghal M, Farah H, Namas A, Al Kaka Z, Abbadi H, Tabalat R, Zubaid M, Rashed W, Saad H, Attiya A, Bahnasy Y, Abdulminam A, Mahmeed WA, Zubaidi A, Bakir S, Al Bustani N, Jabbari S, Sousi A, Agrawal A, Kunju A, Binbrek A, Gabroun A, Ali Y, Bazargani N, Ghanaim MM, Ali S, Wasif AA, Alam S, Sater LA, Adhami A, Al Chall S, Rammal A, Feghali N, Keshishian S, Arnaout S, Atab S, Awad M, Badawi G, Rahal M, Cherri S, Dada S, Hajj A, Daou A, Dergham S, Dib H, Najm Y, ElBayegh H, Mokdad S, Fadel A, Farhat A, Ghanem G, Hachem E, Hamade I, Hobeika R, Ibrahim T, Ismail M, Jazra C, Kaady J, Kaddoura H, Hemadeh M, Karam C, Bizri H, Khoury R, Klait M, Kuwaise A, Sarkis A, Mdayhli A, Mohamad M, Morad K, Mouawad W, Mansour M, Ghandour H, Skakini A, Timani N, Yazbek N, Mroueh G, Hammoud A, Hammouda A, Alturki F, Alwedaa H, Al Amry H, Al Otabi M, El Nemr K, El Motari K, Abdeen G, Al Ghobaish A, Al Bustanji H, Moselhy MS, Eldardery D, Ahmad W, Elshibi K, Khoder WA, Elmahdy N, Eltarabeni A, Tawfiq M, Al-Mashari H, Khalil KM, Hameed A, Yousef MA, Al Kordy M, Hegazy H, Kharafany M, El-Bendary S, El-Aayan A, Shehab Y, Shatoor A, Asseery A, El-Gouzi A, Khaleefa M, El-Harby I, El-Ashgar E, Malek A, Mitwaly O, El-Harch M, Hourany N, Fakeeh B, El-Sayed H, Basher Y, Jameel M, Yassen A, Haddak M, Bendaoud N, Saidane M, Latreche S, Aoudia Y, Ramdani H, Ahnia S, Ghemri S, Chaouche MC, Lehachi S, Kachnoura A, Messaad K, Hammidouche K, Cherif AB, Rahli A, Beddai MF, Manamani L, Meziane T, Kara ZM, Benyoucef N, Ellah D, Moustaghfir A, Darif A, Louali A, Allaoui, Bennis A, Azzouzi L, Saadaoui M, Habbal R, Abdelkhirane C, Fihri OF, Allali Y, Dahreddine A, Hamani A, Ztot S, Chaara A, Bahosse S, Khatouri A, Faik R, El Fath S, Aouchi FB, Riad N, Oudghiri S, Nazzi M, Akoudad H, Tarhbalouti R, Chbil M, Boubel K, Elkhatib S, Mechmech R, Rachid B, Abdeljlil F, Essia B, Faouzi A, Ali BK, Mohamed BF, Salem K, Samir K, Jeridi G, Iheb C, Traki K, Nabil M, Kammoun H, Hassine R, Schamroth C, Corbett C, Krausey M, Ignjatovic G, Kettles D, Theron H, Steyn C, Barnard B, Ebrahim I, Zeelie R, Singh V, Mutati P, Da Silva A, Venter T, Kapp I, Blomerus P, Cassel G, Dalby A, Deseta J, Patel N, Van Der Merwe N, Tayob F, Letcher G, Middlemost S, Essop M, Nunkoon T, Pappachan A, Becker A, Bera Y, Zambakides C, Steingo L, Benjamin J, Commerford P, King J, Khan S, Snyders A, Khan M.

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.

PMID:
22093201
DOI:
10.1016/j.ahj.2011.07.029
[Indexed for MEDLINE]

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