Journal Article

Prevalence and risk factors of atherosclerotic cardiovascular disease in Egyptians with type 2 diabetes: findings from the PACT-MEA study and call for action

Bassyouni, Atef, Gawish, Hanan Sotouhy, Hosny, Salwa Seddik, Toaima, Dalia, Megallaa, Magdy, Massoud, Tarek Mohamed, ElKafrawy, Nabil, Assaad-Khalil, Samir H, Abushady, Manal, El Hefnawy, Hesham

2025

Overview

ObjectivesTo estimate the prevalence of established atherosclerotic cardiovascular disease (eASCVD) and the prevalence of ASCVD high-risk patients as defined by the European Society of Cardiology (ESC) among the Egyptian population of the Prevalence and Clinical Management of Atherosclerotic Cardiovascular Diseases in Patients With Type 2 Diabetes (PACT)-Middle East and Africa study.DesignAn observational, multicentre, cross-sectional study.SettingEight secondary care centres in Egypt.Participants550 adult males and females who provided informed consent and had been diagnosed with type 2 diabetes mellitus (T2DM) for at least 180 days. Participants were excluded if they had participated previously in the study, had been diagnosed with T1DM, experienced mental incapacity, were unwilling to participate, had a known language barrier precluding adequate understanding or cooperation or had a known congenital heart disease or malformation.Primary and secondary outcome measuresThe primary outcome was the proportion of patients with eASCVD, while the secondary outcome was the proportion of patients with T2D with high risk of ASCVD and without eASCVD.ResultsPrevalence of eASCVD was 108/550 (19.6%, 95% CI 16.5% to 23.2%), and the prevalence of high risk for ASCVD in the population without eASCVD was 378/442 (85.5%, 95% CI 81.9% to 88.5%). Approximately 99% of the study population was categorised as ESC very high risk or high risk for CVD. On assessing utilisation of antidiabetic medications with cardiovascular benefit, only 20% were receiving sodium-glucose cotransporter-2 inhibitors, and 3% were receiving glucagon-like peptide-1 analogues.ConclusionsThe prevalence of eASCVD and high risk for ASCVD in Egypt is alarming, and the inadequate pharmacological control increases the ASCVD burden in the T2DM population. This calls for immediate, comprehensive action to reassess T2DM care.Trial registration numberNCT05317845.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adult / Adults / Aged / Agonists / Atherosclerosis / Atherosclerosis - epidemiology / Atherosclerosis - etiology / Cardiovascular Disease / Cross-Sectional Studies / Diabetes / Diabetes and Endocrinology / Diabetes Mellitus, Type 2 / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - drug therapy / Diabetes Mellitus, Type 2 - epidemiology / Egypt - epidemiology / Female / Females / Health risks / Humans / Male / Medical imaging / Middle Aged / Mortality / North African People / Original Research / Prevalence / Risk Factors / Vein & artery diseases