Impact of Socioeconomic Status on In-Hospital Outcome of Patients with Acute Coronary Syndrome in Egypt

El-Adawy, Ahmed Hosny

doi:10.11648/j.cmr.20170606.11

Cited by 2 publications

(1 citation statement)

References 36 publications

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“…Cardiovascular diseases (CVDs) are still the leading cause of death in Egypt and worldwide [ 1 ]. Myocardial infarction and stroke counted for more than 80% of global CVD deaths, 75% of them occurred in low- and middle-income countries [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Testing P2Y12 platelet inhibitors generics beyond bioequivalence: a parallel single-blinded randomized trial

et al. 2022

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Cardiovascular diseases are the leading cause of death worldwide. Ticagrelor is an oral antiplatelet drug used in acute coronary syndrome. Although generic drugs are approved for their bioequivalence to the original product, they are not necessarily to be therapeutically equivalent. This study was conducted to prove the efficacy and safety of ticagrelor generically named Ticaloguard® compared to its brand Brilique® in healthy volunteers. A loading dose of 180 mg ticagrelor named Brilique® or Ticaloguard® followed by a 90 mg twice daily regimen as maintenance dose was given to 14 and 15 volunteers in Tica and Brili groups, respectively. The platelet aggregation on the ADP agonist was assessed at baseline and repeated 1 h and 3 h after the loading dose, on day 4 (after reaching steady-state), 12 and 24 h after discontinuation of the antiplatelet drug. Adverse effects from trial medications were noted by direct questions. It was shown that generic Ticaloguard® provides a similar therapeutic effect and safety as its branded Brilique® (p > 0.05). This will permit safe and trusted use of the generic Ticaloguard® when treating it in the same manner as Brilique®. Testing generic drug effects rather than simple bioequivalency, especially for drugs that are used in critical life-threatening situations, is crucial. We advocate applying this form of a clinical trial to test surrogate clinical efficacy for generics used in critical indications before having real-world data whenever possible.

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Section: Introductionmentioning

confidence: 99%

Testing P2Y12 platelet inhibitors generics beyond bioequivalence: a parallel single-blinded randomized trial

et al. 2022

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Registry for Acute Coronary Events in Nigeria (RACE‐Nigeria): Clinical Characterization, Management, and Outcome

Isezuo

Sani

Talle

et al. 2022

JAHA

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Background Coronary artery disease was hitherto a rarity in Africa. Acute coronary syndrome (ACS) accounts for coronary artery disease–related morbidity and mortality. Reports on ACS in Africa are few. Methods and Results We enrolled 1072 indigenous Nigerian people 59.2±12.4 years old (men, 66.8%) with ACS in an observational multicentered national registry (2013–2018). Outcome measures included incidence, intervention times, reperfusion rates, and 1‐year mortality. The incidence of ACS was 59.1 people per 100 000 hospitalized adults per year, and comprised ST‐segment–elevation myocardial infarction (48.7%), non–ST‐segment–elevation myocardial infarction (24.5%), and unstable angina (26.8%). ACS frequency peaked 10 years earlier in men than women. Patients were predominantly from urban settings (87.3%). Median time from onset of symptoms to first medical contact (patients with ST‐segment–elevation myocardial infarction) was 6 hours (interquartile range, 20.1 hours), and only 11.9% presented within a 12‐hour time window. Traditional risk factors of coronary artery disease were observed. The coronary angiography rate was 42.4%. Reperfusion therapies included thrombolysis (17.1%), percutaneous coronary intervention (28.6%), and coronary artery bypass graft (11.2%). Guideline‐based pharmacotherapy was adequate. Major adverse cardiac events were 30.8%, and in‐hospital mortality was 8.1%. Mortality rates at 30 days, 3 months, 6 months, and 1 year were 8.7%, 9.9%, 10.9%, and 13.3%, respectively. Predictors of mortality included resuscitated cardiac arrest (odds ratio [OR], 50.0; 95% CI, 0.010–0.081), nonreperfusion (OR, 34.5; 95% CI, 0.004–0.221), pulmonary edema (OR, 11.1; 95% CI, 0.020–0.363), left ventricular diastolic dysfunction (OR, 4.1; 95% CI, 0.091–0.570), and left ventricular systolic dysfunction (OR, 2.1; 95% CI, 1.302–3.367). Conclusions ACS burden is rising in Nigeria, and patients are relatively young and from an urban setting. The system of care is evolving and is characterized by lack of capacity and low patient eligibility for reperfusion. We recommend preventive strategies and health care infrastructure‐appropriate management guidelines.

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Impact of Socioeconomic Status on In-Hospital Outcome of Patients with Acute Coronary Syndrome in Egypt

Cited by 2 publications

References 36 publications

Testing P2Y12 platelet inhibitors generics beyond bioequivalence: a parallel single-blinded randomized trial

Testing P2Y12 platelet inhibitors generics beyond bioequivalence: a parallel single-blinded randomized trial

Registry for Acute Coronary Events in Nigeria (RACE‐Nigeria): Clinical Characterization, Management, and Outcome

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