Journal Article

Management of patients with acute ST-elevation myocardial infarction: Results of the FAST-MI Tunisia Registry

Sayahi, Khaled, Monsuez, Jean Jacques, Bouakez, Ahmed, Mulak, Genevieve, Chettaoui, Rafik, Addad, Faouzi, Jullieres, Yves, Gouider, Jeridi, Bataille, Vincent, Boughzela, Essia, Hagege, Albert, Maatouk, Faouzi, Neji, Ali, Sdiri, Wissem, Boujnah, Mohamed Rachid, Haouala, Habib, Gamra, Habib, Baccar, Hedi, Kachboura, Salem, Mourali, Mohamed Sami, Ben Khalfallah, Ali, Guesmi, Ali, Battikh, Kais, Danchin, Nicolas, Milouchi, Sami, Mahdhaoui, Abdallah, Ben Halima, Nejeh, Kamoun, Samir

2019

Overview

The FAST-MI Tunisia registry was set up by the Tunisian Society of Cardiology and Cardiovascular Surgery to assess the demographic and clinical characteristics, management and hospital outcome of patients with ST-elevation myocardial infarction (STEMI). Data for 459 consecutive patients (mean age 60.8 years; 88.5% male) with STEMI, treated in 16 public hospitals (representing 72.2% of public hospitals in Tunisia treating STEMI patients), were collected prospectively.The most common risk factors were smoking (63.6%), hypertension (39.7%), diabetes (32%) and dyslipidaemia (18.2%). Among the 459 patients, 61.8% received reperfusion therapy: 30% with primary percutaneous coronary intervention (PPCI) and 31.8% with intravenous fibrinolysis (IF) (28.6% with pre-hospital thrombolysis). The median time from symptom onset to thrombolysis was 185 min and to PPCI was 358 min. In-hospital mortality was 5.3%. Compared with those managed at regional hospitals, patients managed at interventional university hospitals (n = 357) were more likely to receive reperfusion therapy (52.9% vs. 34.1%; p<0.001), with less IF (28.6% vs. 43.1%; p = 0.002) but more PPCI (37.8% vs. 3.9%; p<0.0001). However, in-hospital mortality in the two types of hospitals was similar (5.3% vs. 5.1%; p = 0.866). Data from the FAST-MI Tunisia registry show that a pharmaco-invasive strategy of management for STEMI should be promoted in non-interventional regional hospitals.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acute coronary syndromes / Adult / Aged / Aged, 80 and over / Angioplasty / Angioplasty, Balloon, Coronary - methods / Angioplasty, Balloon, Coronary - mortality / Angioplasty, Balloon, Coronary - statistics & numerical data / Balloon angioplasty / Biology and Life Sciences / Cardiac patients / Cardiology / Cardiology and cardiovascular system / Cardiovascular disease / Care and treatment / Computer and Information Sciences / Demographics / Diabetes mellitus / Dyslipidemia / Electrocardiography / Female / Fibrinolysis / Fibrinolytic Agents - therapeutic use / Health aspects / Heart attack / Heart attacks / Hospital Mortality / Hospitals / Hospitals, Public - statistics & numerical data / Hospitals, University - statistics & numerical data / Human health and pathology / Humans / Hypertension / Intravenous administration / Life Sciences / Male / Management / Medicine and Health Sciences / Middle Aged / Mortality / Myocardial infarction / Non-pharmacological intervention / Patients / People and Places / Percutaneous Coronary Intervention - methods / Percutaneous Coronary Intervention - mortality / Percutaneous Coronary Intervention - statistics & numerical data / Pharmacology / Professional associations / Public hospitals / Registries - statistics & numerical data / Reperfusion / Risk analysis / Risk factors / Smoking / ST Elevation Myocardial Infarction - diagnosis / ST Elevation Myocardial Infarction - epidemiology / ST Elevation Myocardial Infarction - therapy / Surgery / Tenecteplase / Therapy / Thrombolysis / Thrombolytic Therapy - mortality / Thrombolytic Therapy - statistics & numerical data / Tirofiban / Treatment Outcome / Trends / Tunisia - epidemiology