Low-resource countries benefit from global STEMI initiative

A global registry of heart attack patients from low-income and middle-income countries indicated continuing improved trends for key clinical outcomes, including mortality, as reported in the new 2-year readout of the programme.

Prof. Cesar Herrera (Montefiore-Einstein Center for Heart and Vascular Care, NY, USA) presented the new 2-year analysis from the Global Heart Attack Treatment Initiative (GHATI), which compared deidentified patient information from 2019 to 2021 [1]. At 2 years, GHATI had tracked treatment metrics from >4,000 patients with ST-elevation myocardial infarction (STEMI) from 39 medical centres in 18 countries in low-middle income countries on 5 continents.

The results showed significant improvements in the clinical combined endpoints of shock on arrival, arrest before/after intervention, the incidence of ejection fraction <40%, and survival rates at discharge since the start of the programme. High rates of reperfusion therapy (95%) were observed, and the study reported good adherence to guideline-directed medical therapy (92%). Prof. Herrera also remarked that the time was <90 minutes from the point of first medical contact to percutaneous coronary intervention for at least 75% of patients who required that intervention, which was better than anticipated. The recommended goal of achieving reperfusion within 90 minutes for at least 90% of STEMI patients is still an opportunity for further improvement in the future.

“The great thing about registries is that once you tell people what you are measuring and why, just the fact that people are measuring and caring about those metrics can have a tremendous effect (on performance),” Dr Herrera said. “To see the continuing improvements over time is pretty amazing.”

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   1. Herrera CJ, et al. Improving STEMI Management Internationally: Two-year Report Of 4,015 Patients Enrolled In The American College Of Cardiology - Global Heart Attack Treatment Initiative (GHATI). Abstract 410–08, ACC 2022, 2–4 April, Washington DC, USA.

 

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Posted on 15 June 202213 June 2024