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Al Saleh A, Jamee A, Sulaiman K, Sobhy M, Gamra H, Alkindi F, Benkhedda S, Al-Motarreb A, Amin MI, Almahmeed W, Hammoudeh A, Skouri H, Farhan HA, Al Jarallah M, Fellat N, Panduranga P, Alnajm BK, Abdelhamid M, Refaat R, Amor H, Messaous S, Ahmed HS, Chibane A, AbdulMalek A, Alsagheer NK, Dada S, Mokhtar Z, Ali M, Ullah A, AlBackr H, Alhabib KF. Clinical features, socioeconomic status, management, short and long-term outcomes of patients with acute myocardial infarction: Phase I results of PEACE MENA registry. PLoS One 2024; 19:e0296056. [PMID: 38206951 PMCID: PMC10783754 DOI: 10.1371/journal.pone.0296056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The Program for the Evaluation and Management of Cardiac Events in the Middle East and North Africa (PEACE MENA) is a prospective registry program in Arabian countries that involves in patients with acute myocardial infarction (AMI) or acute heart failure (AHF). METHODS This prospective, multi-center, multi-country study is the first report of the baseline characteristics and outcomes of inpatients with AMI who were enrolled during the first 14-month recruitment phase. We report the clinical characteristics, socioeconomic, educational levels, and management, in-hospital, one month and one-year outcomes. RESULTS Between April 2019 and June 2020, 1377 patients with AMI were enrolled (79.1% males) from 16 Arabian countries. The mean age (± SD) was 58 ± 12 years. Almost half of the population had a net income < $500/month, and 40% had limited education. Nearly half of the cohort had a history of diabetes mellitus, hypertension, or hypercholesterolemia; 53% had STEMI, and almost half (49.7%) underwent a primary percutaneous intervention (PCI) (lowest 4.5% and highest 100%). Thrombolytics were used by 36.2%. (Lowest 6.45% and highest (90.9%). No reperfusion occurred in 13.8% of patients (lowest was 0% and highest 72.7%).Primary PCI was performed less frequently in the lower income group vs. high income group (26.3% vs. 54.7%; P<0.001). Recurrent ischemia occurred more frequently in the low-income group (10.9% vs. 7%; P = 0.018). Re-admission occurred in 9% at 1 month and 30% at 1 year, whereas 1-month mortality was 0.7% and 1-year mortality 4.7%. CONCLUSION In the MENA region, patients with AMI present at a young age and have a high burden of cardiac risk factors. Most of the patients in the registry have a low income and low educational status. There is heterogeneity among key performance indicators of AMI management among various Arabian countries.
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Affiliation(s)
- Ayman Al Saleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Amal Jamee
- Nassar Medical Complex Hospital, Ministry of Health, Khan Younes, Gaza Strip, Palestine
- Al-Quds Hospital, Gaza, Palestine
| | | | - Mohamed Sobhy
- International Cardiac Center (ICC), Alexandria, Egypt
| | - Habib Gamra
- Research Laboratory LR, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Fahad Alkindi
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Salim Benkhedda
- Cardiology Department, Mustapha Hospital, COCRG Laboratory University Benyoucef Benkhedda, Algiers, Algeria
| | | | | | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirate
| | | | - Hadi Skouri
- Cardiology Division, Internal Medicine Department at American University of Beirut Medical Center, Beirut, Lebanon
| | - Hasan A. Farhan
- Iraqi Board for Medical Specializations, Scientific Council of Cardiology. Baghdad Heart Center, Medical City, Baghdad, Iraq
| | | | | | | | | | - Magdy Abdelhamid
- Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Giza Governorate, Egypt
| | - Rafik Refaat
- International Cardiac Center (ICC), Alexandria, Egypt
| | - Hassen Amor
- Taher Sfar University Hospital, Mahdia, Tunisia
| | - Salma Messaous
- Research Laboratory LR, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | | | - Ahcene Chibane
- Internal Medicine and Cardiology Department, CHU Douéra, Algiers, University Saad Dahlab, Blida, Algeria
| | - Azzouz AbdulMalek
- Cardiology Department, Mustapha Hospital, COCRG Laboratory University Benyoucef Benkhedda, Algiers, Algeria
| | | | - Sobhi Dada
- Hammoud University Medical Center, Saida, Lebanon
| | - Zaki Mokhtar
- King Saud Hospital, Unizah, Qaseem, Saudi Arabia
| | | | - Anhar Ullah
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Hanan AlBackr
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Khalid F. Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
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Remedios-Carbonell LE, Arteaga-Guerra D, Prieto-Guerra M, Martinez-Garcia G, Santos-Medina M, Rodriguez-Ramos M. Quality of care for patients with ST-segment Elevation Myocardial Infarction before COVID-19 pandemic in Cuba: review of 17 reports with 7823 patients. REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS 2023; 80:538-558. [PMID: 38150200 PMCID: PMC10851390 DOI: 10.31053/1853.0605.v80.n4.42094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND In Cuba, there is neither a registry of ST Elevation Myocardial Infarction (STEMI), nor are analysis of performance measures widely reported. OBJECTIVE A review of Cuban studies of patients with STEMI was carried out to describe quality of medical care. METHODS Cochrane Library, EMBASE, PubMed, Scopus and SciELO, as well as archives of national journals, were all searched for articles on STEMI in Cuba, from 2000 to March 2020. They were included if they reported number or percentage of application of reperfusion therapy; administration of aspirin, enalapril-captopril (ACEI) or beta-blockers; status of patients at discharge; and patient or system delay times. Finally, 17 reports with 7823 patients were included. RESULTS Thrombolytic therapy was administered to 3991 patients (51%), and 695 patients (8.9%) died. Only four studies, with 880 patients, presented data about prescription of ACEI, aspirin, and beta-blockers, which were administered to 381 (45.3%), 824 (93.6%), 464 (52.7%) patients, respectively. Coronary intervention was reported in 5 studies with 3422 patients, being performed in 661 (19.3%). Conclusions: Quality of care of patients with STEMI seems to be poorer than reported in similar scenarios. Thrombolytic administration is still low, although mortality decreases in this period. Other pharmacological treatments were insufficiently fulfilled.
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Yogeswaran V, Hidano D, Diaz AE, Van Spall HGC, Mamas MA, Roth GA, Cheng RK. Regional variations in heart failure: a global perspective. Heart 2023; 110:11-18. [PMID: 37353316 DOI: 10.1136/heartjnl-2022-321295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 06/06/2023] [Indexed: 06/25/2023] Open
Abstract
Heart failure (HF) is a global public health concern that affects millions of people worldwide. While there have been significant therapeutic advancements in HF over the last few decades, there remain major disparities in risk factors, treatment patterns and outcomes across race, ethnicity, socioeconomic status, country and region. Recent research has provided insight into many of these disparities, but there remain large gaps in our understanding of worldwide variations in HF care. Although the majority of the global population resides across Asia, Africa and South America, these regions remain poorly represented in epidemiological studies and HF trials. Recent efforts and registries have provided insight into the clinical profiles and outcomes across HF patterns globally. The prevalence of HF and associated risk factors has been reported and varies by country and region ranges, with minimal data on regional variations in treatment patterns and long-term outcomes. It is critical to improve our understanding of the different factors that contribute to global disparities in HF care so we can build interventions that improve our general cardiovascular health and mitigate the social and economic cost of HF. In this narrative review, we hope to provide an overview of the global and regional variations in HF care and outcomes.
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Affiliation(s)
| | - Danelle Hidano
- Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Andrea E Diaz
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Harriette G C Van Spall
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Newcastle, UK
| | - Gregory A Roth
- Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Richard K Cheng
- Division of Cardiology, University of Washington, Seattle, Washington, USA
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Alharrasi M, Isac C, Kamanyire JK. Heart Failure Burden in Oman as a Mid-East Exemplar Versus Global Perspectives: An Integrative Review. J Saudi Heart Assoc 2023; 35:214-225. [PMID: 37700756 PMCID: PMC10495046 DOI: 10.37616/2212-5043.1345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Abstract
Heart failure (HF), a clinical syndrome caused by a structural and functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and pulmonary congestion. This study intends to investigate the state of heart failure (HF) in Oman and assess it in comparison of global trends. Ten published literatures from the past 20 years were included after a thorough search of databases (Arab World Research Source, EBSCOhost, Medline, and Google Scholar). These studies were reviewed considering the global literature. We have observed an increase in HF cases especially in older adults, over the past two decades in Oman. Acute coronary syndrome and non-compliance with medication are two factors that contribute to acute HF, according to recent research. Ischemic heart disease is the leading cause of HF in the Omani population. The mortality rate for HF patients in Oman was reported to be 25% after a one-year follow-up. The younger population that is diagnosed with HF in Oman is significantly worse than in other nations, according to these data, which are consistent with global trends. The lack of published studies and data sets hampered our understanding of heart failure (HF); yet prevalence of HF is rising and is anticipated to surge with the rise in diabetes mellitus and hypertension and other related cardiovascular precursors. Therefore, HF requires more investigation. In terms of worldwide trends, HF in Oman appears to be even worse; additional information is required to grasp the full picture on HF.
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Manla Y, Almahmeed W. The Pandemic of Coronary Heart Disease in the Middle East and North Africa: What Clinicians Need to Know. Curr Atheroscler Rep 2023; 25:543-557. [PMID: 37615785 PMCID: PMC10471667 DOI: 10.1007/s11883-023-01126-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE OF REVIEW Coronary heart disease (CHD) is the leading cause of morbidity, mortality, and disability in the Middle East and North Africa (MENA). While the prevention, diagnosis, and management of CHD have been detailed in international guidelines, we aimed in this review to quantify the pandemic of CHD in the MENA region and highlight regional patient characteristics, clinical challenges, and future directions to optimize CHD care in the region. RECENT FINDINGS Patients with CHD in the MENA feature younger age at presentation and worse prognosis in women. Despite the high burden of CHD risk factors, many of these factors remain underrecognized, undertreated, and uncontrolled. Additionally, CHD care is hampered by poor patient awareness, inefficient preventive strategies, and limited access to guideline-recommended therapeutics. All stakeholders involved in healthcare should work together to develop and execute strategies aimed at tackling the burden of CHD in the MENA.
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Affiliation(s)
- Yosef Manla
- Department of Cardiology, Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Wael Almahmeed
- Department of Cardiology, Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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Muscoli S, Andreadi A, Tamburro C, Russo M, Rosenfeld R, Oro P, Ifrim M, Porzio F, Barone L, Barillà F, Lauro D. Prevalence of Cardiovascular Risk Factors and Coronary Angiographic Findings in High-Risk Immigrant Communities in Italy. J Pers Med 2023; 13:882. [PMID: 37373871 DOI: 10.3390/jpm13060882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The prevalence of coronary artery disease (CAD) considerably varies by ethnicity. High-risk populations include patients from Eastern Europe (EEP), the Middle East and North Africa (MENAP) and South Asia (SAP). METHODS This retrospective study aims to highlight cardiovascular risk factors and specific coronary findings in high-risk immigrant groups. We examined the medical records and coronary angiographies of 220 patients from the above-mentioned high-risk ethnic groups referred for Acute Coronary Syndrome (ACS) and compared them with 90 Italian patients (IP) from 2016 to 2021. In the context of high-risk immigrant populations, this retrospective study aims to shed light on cardiovascular risk factors and particular coronary findings. We analyzed the medical records of 220 patients from the high-risk ethnic groups described above referred for ACS and compared them with 90 IPs between 2016 and 2021. In addition, we assessed coronary angiographies with a focus on the culprit lesion, mainly evaluating multi-vessel and left main disease. RESULTS The mean age at the first event was 65.4 ± 10.2 years for IP, 49.8 ± 8.5 years for SAP (Relative Reduction (ReR) 30.7%), 51.9 ± 10.2 years for EEP (ReR 26%) and 56.7 ± 11.4 years for MENAP (ReR 15.3%); p < 0.0001. The IP group had a significantly higher prevalence of hypertension. EEP and MENAP had a lower prevalence of diabetes. EEP and MENAP had a higher prevalence of STEMI events; SAP showed a significant prevalence of left main artery disease (p = 0.026) and left anterior descending artery disease (p = 0.033) compared with other groups. In SAP, we detected a higher prevalence of three-vessel coronary artery disease in the age group 40-50. CONCLUSIONS Our data suggest the existence of a potential coronary phenotype in several ethnicities, especially SAP, and understate the frequency of CV risk factors in other high-risk groups, supporting the role of a genetic influence in these communities.
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Affiliation(s)
- Saverio Muscoli
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Aikaterini Andreadi
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
- Division of Endocrinology and Diabetology, Department of Medical Sciences, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Claudia Tamburro
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Massimo Russo
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Roberto Rosenfeld
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Pietro Oro
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Mihaela Ifrim
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Federica Porzio
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Lucy Barone
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Francesco Barillà
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Davide Lauro
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
- Division of Endocrinology and Diabetology, Department of Medical Sciences, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
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Gtif I, Bouzid F, Charfeddine S, Abid L, Kharrat N. Heart failure disease: An African perspective. Arch Cardiovasc Dis 2021; 114:680-690. [PMID: 34563468 DOI: 10.1016/j.acvd.2021.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
Heart failure remains a health challenge in Africa, associated with significant rates of hospitalization, morbidity and mortality. The current review aims to summarize the most recent data on the epidemiology, aetiology, risk factors and management of heart failure, comparing countries in North Africa and sub-Saharan Africa. There is a paucity of data on heart failure epidemiology, aetiology and management, and on the sociodemographic characteristics of African patients with heart failure. Heart failure prevalence has been evaluated among all medical admissions or admissions to cardiac units or emergency departments in a few hospital-based studies conducted in countries in North Africa and sub-Saharan Africa. Common causes of heart failure in Africa include ischaemic heart disease, hypertensive heart disease, dilated cardiomyopathy and valvular heart disease. The aetiology of heart failure differs between countries in North Africa and sub-Saharan Africa. Diagnosing heart failure proves challenging in Africa because of a lack of basic tools and the necessary human resources. The principal drugs used frequently for heart failure therapy are lacking in sub-Saharan Africa. The clinical profile of heart failure in sub-Saharan Africa differs from that in North African countries; this is related to aetiological factors, socioeconomic status and availability of diagnostic tools. There is an evident need to establish a large multicentre registry to evaluate the heart failure burden in almost all African countries, and to highlight the major cardiovascular risk factors and co-morbidities. The present review highlights the importance of this syndrome in Africa, and calls for improvements in its early diagnosis, treatment and, possibly, prevention.
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Affiliation(s)
- Imen Gtif
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, University of Sfax, Sidi Mansour, 3061 Sfax, Tunisia.
| | - Fériel Bouzid
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, University of Sfax, Sidi Mansour, 3061 Sfax, Tunisia
| | - Salma Charfeddine
- Department of Cardiology, Hédi Chaker University Hospital, Faculty of Medicine of Sfax, University of Sfax, 3000 Sfax, Tunisia
| | - Leila Abid
- Department of Cardiology, Hédi Chaker University Hospital, Faculty of Medicine of Sfax, University of Sfax, 3000 Sfax, Tunisia
| | - Najla Kharrat
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, University of Sfax, Sidi Mansour, 3061 Sfax, Tunisia
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Xing J, Liu J, Geng T. Predictive values of sST2 and IL-33 for heart failure in patients with acute myocardial infarction. Exp Biol Med (Maywood) 2021; 246:2480-2486. [PMID: 34342552 DOI: 10.1177/15353702211034144] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Timely prediction of the risk of heart failure in acute myocardial infarction patients is critical for better prognosis. This article aims to evaluate the predictive value of serum soluble growth stimulation expressed gene 2 (sST2) and interleukin-33 in patients with acute myocardial infarction complicated by heart failure. A total of 42 healthy controls and 144 acute myocardial infarction patients were recruited in the study. According to Killip cardiac function classification as the basis for concurrent heart failure, they were distributed into non-heart failure group (n = 76) and heart failure group (n = 68). ELISA was utilized to determine the serum sST2 and interleukin-33 levels, and the diagnostic efficiency was evaluated by receiver operating characteristics curve. sST2 and interleukin-33 levels in patients with acute myocardial infarction were significantly increased when compared with normal healthy controls, and were further enhanced in the heart failure group. With the increased Killip cardiac function classification, interleukin-33 and sST2 levels were gradually elevated. Multivariate analysis indicated that interleukin-33 and sST2 could be used as independent predictors for heart failure combined with acute myocardial infarction.
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Affiliation(s)
- Jingxian Xing
- Second Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou 061001, China
| | - Junyan Liu
- Second Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou 061001, China
| | - Tao Geng
- Second Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou 061001, China
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Correction: Acute Myocardial Infarction and Acute Heart Failure in the Middle East and North Africa: Study Design and Pilot Phase Study Results from the PEACE MENA Registry. PLoS One 2021; 16:e0246036. [PMID: 33503059 PMCID: PMC7840000 DOI: 10.1371/journal.pone.0246036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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