Patients with AMI in the MENA region present at a relatively young age with a high burden of risk factors, and significant socioeconomic disparities exist in access to primary PCI.
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.
Saleh et al. (Thu,) studied this question.