Global Perspective on Acute Coronary Syndrome

Abstract

Ischemic heart disease (IHD) is the greatest single cause of mortality and loss of disability-adjusted life years (DALYs) worldwide, and a substantial portion of this burden falls on low- and middle-income countries (LMICs). Deaths from IHD and acute coronary syndrome (ACS) occur, on average, at younger ages in LMICs than in high-income countries, often at economically productive ages, and likewise frequently affect the poor within LMICs. While data regarding ACS in LMICs are limited, there is a growing literature in this area and the research gaps are being steadily filled. In high-income countries, decades of investigation into the risk factors for ACS and development of behavioral programs, medications, interventional procedures, and guidelines have provided us with the tools to prevent and treat events. Although similar tools can be, and in fact have been, implemented in many LMICs, challenges remain in the development and implementation of cardiovascular health promotion activities across the entire life course, as well as in access to treatment for ACS and IHD. Intersectoral policy initiatives and global coordination are critical elements of ACS and IHD control strategies. Addressing the hurdles and scaling successful health promotion, clinical and policy efforts in LMICs are necessary in order to adequately address the global burden of ACS and IHD.

Quality of Life among Patients with Acute Coronary Syndrome

“…It includes unstable angina (UA), non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI) (3,4). Acute Coronary Syndrome is one of the leading causes of death and disability worldwide, accounting for approximately seven million deaths and 129 million disabilities annually (5,6). Acute Coronary Syndrome affects many aspects of patient's life including, including: physical, psychological, emotional and social (7) .…”

“…The results of these studies may or may not be applicable to the people at the developing countries. Moreover, ACS is responsible for the majority of the CVDs deaths worldwide including Jordan (5,6). Therefore, the major purpose of this study was to describe the QoL for patients with ACS in Jordan.…”

Molecular Basis of Cardioprotection

“…[1][2][3][4] The infarct size (IS) resulting from both ischemia-and reperfusion-induced injury is a major determinant of the prognosis of patients who have survived their acute myocardial infarction (AMI) event. [5][6][7][8][9] Now, given that (1) the prevalence of IHD is increasing not only in developed but also in developing countries, 10,11 (2) an increasing number of patients survive their AMI, largely secondary to timely reperfusion and better medical treatment options, 12,13 and (3) many of these patients have progressive myocardial remodeling and eventual heart failure, 14 cardioprotection beyond that by reperfusion is urgently needed with the aim to minimize IS as the main determinant of evolving heart failure. There is currently no stronger cardioprotection than that by the conditioning phenomena.…”

Antiplatelet Agents in Acute Coronary Syndromes

“…1 In Brazil, it is estimated to be related to an annual rate of approximately 55 deaths per 100,000 inhabitants. 2,3 Acute coronary syndrome (ACS), with its broad range of manifestations, takes on a leading role in these statistics, and myocardial revascularization procedures and antithrombotic pharmacotherapy are fundamental pillars of its treatment.…”