The management of acute myocardial infarction in developing countries

The Saudi Project for Assessment of Coronary Events (SPACE) registry: Design and results of a phase I pilot study

“…Data from other registries show that the prevalence of DM ranges from 21% to 33% (15,17,18). To our knowledge, the prevalence in our study is higher than what has been reported in any other ACS registry (15,(17)(18)(19). The reasons for this finding are unclear; however, some plausible explanations are rising obesity rates, sedentary lifestyle, poor dietary habits and high rates of consanguinity (20,21).…”

Optimizing the management of acute coronary syndromes in sub-Saharan Africa: A statement from the AFRICARDIO 2015 Consensus Team

“…• increase awareness of and education about ACS symptoms to improve recognition, by both patients and first-line emergency healthcare providers or paramedics in rural areas; • train rural-based healthcare professionals in preventive cardiology and the diagnosis of cardiovascular emergencies; • first-line healthcare facilities in rural areas should have high numbers of general practitioners or experienced paramedics who are trained to provide health counselling and emergency care; they should be aware of the importance of reducing delays in managing patients with a suspected diagnosis of STEMI, thereby fast-tracking patients to receive appropriate electrocardiographic examinations and treatment in a first-line referral infirmary; • first-line healthcare facilities or infirmaries in small cities or covering rural community areas should be equipped with an electrocardiogram (ECG) and be served by a physician trained in minimal ECG interpretation; transmission of the ECG to the referral cardiology department by mail, fax or mobile phone should be available suitable for appropriate analysis if required; early antithrombotic therapy with 250 mg intravenous aspirin and 300 mg oral clopidogrel should be administered after a diagnosis of ACS has been confirmed or is strongly suspected; • emergency rooms in larger towns or small cities should be able to make the decision to start fibrinolytic therapy associated with heparin; a fibrinolytic drug -at least streptokinase -and unfractionated or low-molecularweight heparin should be available in the hospital pharmacy; fibrinolytic therapy is recommended within 12 hours of symptom onset in STEMI patients without contraindications; • as recommended in high-income countries [14], optimal treatment should be based on the implementation of predefined networks between primary care facilities in rural areas, first-line medical facilities in towns and small cities, and cardiology referral centres in large cities; • co-operation between hospital-based cardiology departments, catheterization laboratories and the EMS should be clearly defined, including when prehospital fibrinolytic therapy by the EMS and hospital-based PCI is affordable; • given the excessively long delays that preclude revascularization attempts in too many instances, one would expect that a network approach will result in a substantial reduction in delays, as well as in the appropriate selection of either a pharmacoinvasive rescue PCI-coupled approach or a PCI-alone approach in some instances, mainly in patients from large cities [27][28][29][30]; • optimizing primary PCI approaches in large equipped cities should be coupled to enhanced prehospital urban and suburban EMS policies to reduce time-to-balloon delays in patients eligible for primary PCI; • patients with ACS should be listed in a referral centrebased registry.…”

Effects of LDL and Oxidized LDL on Cardiac Function in Isoproterenol-induced Myocardial Infarction in Rat

“…Lipid profi les of diff erent groups were shown in • ▶ Table 1 . The results indicated that the levels of serum LDL, cholesterol and triglycerides were signifi cantly higher in groups fed with cholesterol and OxChol-rich diets compared to the control group (P < 0.001).…”