Background This pilot study describes the overall design and results of the Program for the Evaluation and Management of the Cardiac Events registry for the Middle East and North Africa (MENA) Region. Methods This prospective, multi-center, multi-country study included patients hospitalized with acute myocardial infarction (AMI) and/or acute heart failure (AHF). We evaluated the clinical characteristics, socioeconomic and educational levels, management, in-hospital outcomes, and 30-day mortality rate of patients that were admitted to one tertiary-care center in each of 14 Arab countries in the MENA region. Results Between 22 April and 28 August 2018, 543 AMI and 381AHF patients were enrolled from 14 Arab countries (mean age, 57±12 years, 82.5% men). Over half of the patients in both study groups had low incomes with limited health care coverage, and limited education. Nearly half of the cohort had a history of diabetes mellitus, hypertension, or hypercholesterolemia.

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Acute stent malapposition poses a significant risk for adverse cardiac events following percutaneous coronary intervention. Detection of acute stent malapposition traditionally relies on intracoronary imaging techniques, such as intravascular ultrasound and optical coherence tomography, which may be limited in developing countries due to accessibility issues. A new angiographic sign called the POT-PUFF sign has been introduced as a potential alternative for detecting malapposition during coronary bifurcation procedures. Here, we present two clinical cases from a developing country where the POT-PUFF sign was employed to assess the result of proximal optimization therapy after stent implantation. The POT-PUFF sign exhibits potential as an affordable and feasible approach for assessing stent malapposition in settings with limited resources.

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