Nationwide STEMI care in Armenia demonstrated near-universal use of guideline-directed reperfusion therapy, with 96.8% of patients undergoing PCI and an overall in-hospital mortality rate of 3.1%.
Observational (n=2,222)
Yes
The ARMI registry demonstrates near-universal use of guideline-directed reperfusion therapy for STEMI in Armenia, with a favorable in-hospital mortality rate of 3.1%.
Abstract Background Coronary artery disease is the leading cause of mortality in Armenia, accounting for approximately 40% of all deaths. Timely reperfusion therapy is essential in patients with ST-segment elevation myocardial infarction (STEMI), as treatment delays significantly increase mortality. The Armenian National Registry of Myocardial Infarction (ARMI) represents the first nationwide, multicenter STEMI registry in Armenia. Objectives The primary objective was to determine the in-hospital mortality rate among patients with STEMI admitted to participating hospitals. Secondary objectives included comparing 30-day and 12-month cardiovascular and all-cause mortality and rehospitalization rates, assessing the impact of geographic time delays on outcomes, evaluating adherence to international reperfusion guidelines, and establishing a biobank for future translational research. Methods The registry prospectively enrolled consecutive adults aged 18–93 years admitted with STEMI within 48 hours of symptom onset across 13 hospitals nationwide, including major centers in Yerevan and regional sites. Trained investigators collected clinical data using a secure, national REDCap database. Enrollment ran from December 1, 2023, to July 1, 2025. All patients are followed for one year with 30-day and 12-month assessments. Results A total of 2,222 patients were enrolled. The majority were male (81.1%; n=1,786), and 18.9% (n=416) were female. Percutaneous coronary intervention (PCI) was performed in 2,098 patients (96.8%), of whom 2,090 (99.6%) underwent primary PCI. Medical therapy alone was used in 58 patients (2.7%), while 12 patients (0.6%) underwent coronary artery bypass grafting. Reinfarction occurred in 9 patients (3.4%) and recurrent ischemia in 11 patients (4.2%). The in-hospital mortality rate was 3.1% (n=67), of which 91.0% were cardiovascular in origin. Conclusions Initial ARMI data demonstrate near-universal use of guideline-directed reperfusion therapy in Armenia and a favorable in-hospital mortality rate of 3.1%, comparable to outcomes from European STEMI registries. ARMI establishes the first national benchmark for STEMI care in Armenia and provides critical infrastructure for ongoing quality improvement, future clinical trials, and translational research.
Hayrapetyan et al. (Fri,) conducted a observational in ST-segment elevation myocardial infarction (STEMI) (n=2,222). Nationwide STEMI care in Armenia demonstrated near-universal use of guideline-directed reperfusion therapy, with 96.8% of patients undergoing PCI and an overall in-hospital mortality rate of 3.1%.