Characteristics of patients with first occurrence of ST-segment Elevation Myocardial Infarction in Algeria: The STAMI registry

Abstract

Few data are available on the management of acute myocardial infarction (MI) and risk assessment after MI in Algeria. The STAMI registry is a prospective, multicenter, non-interventional study conducted in fourteen public and private hospitals in the central, eastern, western but also in the Sahara containing a cardiac intensive care unit (with and without PCI facilities). Enrollment started in November 2016 for a 2-month period. The primary Outcome Measures major adverse cardiac and cerebrovascular events during hospitalization. Additional outcomes include the delay between onset of symptoms and hospitalization, the types of reperfusion management and MACCE at 1 month and 1 year after discharge from hospital. A total of 327 patients were enrolled. The majority were male 260 (79.5%) and was younger (Men 59.4 ± 11.8 years) women 63.9 ± 13.1 years). Smoking (45,5%, n = 150), hypertension (39,9%, n = 130), and diabetes (35.2%, n = 116) were the main risk factors; a history of coronary dieses was reported in less 5% of the patients. Reperfusion therapy was performed in 285 (86.5%) patients (56.9%, n = 188 thrombolytic therapy and 29.4%, n = 97 primary PCI). The median time since symptom onset to hospitalization is 349mn. A total of 67.8% ( n = 224) of the patients were issued from another healthcare facility. Major adverse cardiovascular events occurred in 5.5% ( n = 18) and the in-hospital mortality was 2.1%. Those first in hospital results on Algerian STEMI patients revealed that a large percentage of patients benefit from a strategy of reperfusion, the thrombolysis remains the most used, but the delays of management and reperfusion of patients are long, more than 5 h. The rate of intra-hospital complications is relatively low and may have several explanations, the most important seems to be of which is the low risk of patients enrolled. This is probably related to the current management of STEMI in Algeria, the most severe patients do not arrive at cardiac centers.