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Clinical features, socioeconomic status, management, short and long-term outcomes of patients with acute myocardial infarction: Phase I results of PEACE MENA registry

Al Saleh A 1 , Jamee A 2 , Sulaiman K 3 , Sobhy M 4 , Gamra H 5 , Alkindi F 6 Show all authors , Benkhedda S 7 , Al-Motarreb A 8 , Amin MI 9 , Almahmeed W 10 , Hammoudeh A 11 , Skouri H 12 , Farhan HA 13 , Al Jarallah M 14 , Fellat N 15 , Panduranga P 3 , Alnajm BK 16 , Abdelhamid M 17 , Refaat R 4 , Amor H 18 , Messaous S 5 , Ahmed HS 6 , Chibane A 19 , AbdulMalek A 7 , Alsagheer NK 20 , Dada S 21 , Mokhtar Z 22 , Ali M 23 , Ullah A 1 , AlBackr H 1 , Alhabib KF 1

Affiliations 

  • 1 Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
  • 2 Nassar Medical Complex Hospital, Ministry of Health, Khan Younes, Gaza Strip, Palestine
  • 3 National Heart Center, Royal Hospital, Muscat, Oman
  • 4 International Cardiac Center (ICC), Alexandria, Egypt
  • 5 Research Laboratory LR, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
  • 6 Heart Hospital, Hamad Medical Corporation, Doha, Qatar
  • 7 Cardiology Department, Mustapha Hospital, COCRG Laboratory University Benyoucef Benkhedda, Algiers, Algeria
  • 8 Faculty of Medicine, Sana'a University, Sana'a, Yemen
  • 9 Mohamed Bin Khalifa Cardiac Centre, Awali, Bahrain
  • 10 Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirate
  • 11 Cardiology Department, Istishari Hospital, Amman, Jordan
  • 12 Cardiology Division, Internal Medicine Department at American University of Beirut Medical Center, Beirut, Lebanon
  • 13 Iraqi Board for Medical Specializations, Scientific Council of Cardiology. Baghdad Heart Center, Medical City, Baghdad, Iraq
  • 14 Sabah Al Ahmed Cardia Center, Kuwait City, Kuwait
  • 15 IBN SINA University Hospital, Rabat, Morocco
  • 16 Al Nahdha Hospital, Muscat, Oman
  • 17 Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Giza Governorate, Egypt
  • 18 Taher Sfar University Hospital, Mahdia, Tunisia
  • 19 Internal Medicine and Cardiology Department, CHU Douéra, Algiers, University Saad Dahlab, Blida, Algeria
  • 20 Althawra Modern General Hospital, Sana'a, Yemen
  • 21 Hammoud University Medical Center, Saida, Lebanon
  • 22 King Saud Hospital, Unizah, Qaseem, Saudi Arabia
  • 23 Saudi Heart Association, Riyadh, Saudi Arabia
PLoS One, 2024;19(1):e0296056.
PMID: 38206951 DOI: 10.1371/journal.pone.0296056

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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