Management of patients with acute ST-elevation myocardial infarction: Results of the FAST-MI Tunisia Registry

Faouzi Addad, Abdallah Mahdhaoui, Jeridi Gouider, Essia Boughzela, Samir Kamoun, Mohamed Rachid Boujnah, Habib Haouala, Habib Gamra, Faouzi Maatouk, Ali Ben Khalfallah, Salem Kachboura, Hedi Baccar, Nejeh Ben Halima, Ali Guesmi, Khaled Sayahi, Wissem Sdiri, Ali Neji, Ahmed Bouakez, Sami Milouchi, Kais Battikh, Yves Jullieres, Nicolas Danchin, Jean Jacques Monsuez, Genevieve Mulak, Albert Hagege, Vincent Bataille, Rafik Chettaoui, Mohamed Sami Mourali, FAST-MI Tunisia investigators, Faouzi Addad, Abdallah Mahdhaoui, Jeridi Gouider, Essia Boughzela, Samir Kamoun, Mohamed Rachid Boujnah, Habib Haouala, Habib Gamra, Faouzi Maatouk, Ali Ben Khalfallah, Salem Kachboura, Hedi Baccar, Nejeh Ben Halima, Ali Guesmi, Khaled Sayahi, Wissem Sdiri, Ali Neji, Ahmed Bouakez, Sami Milouchi, Kais Battikh, Yves Jullieres, Nicolas Danchin, Jean Jacques Monsuez, Genevieve Mulak, Albert Hagege, Vincent Bataille, Rafik Chettaoui, Mohamed Sami Mourali, FAST-MI Tunisia investigators

Abstract

Background: The FAST-MI Tunisia registry was set up by the Tunisian Society of Cardiology and Cardiovascular Surgery to assess the demographic and clinical characteristics, management and hospital outcome of patients with ST-elevation myocardial infarction (STEMI).

Methods: Data for 459 consecutive patients (mean age 60.8 years; 88.5% male) with STEMI, treated in 16 public hospitals (representing 72.2% of public hospitals in Tunisia treating STEMI patients), were collected prospectively.The most common risk factors were smoking (63.6%), hypertension (39.7%), diabetes (32%) and dyslipidaemia (18.2%).

Results: Among the 459 patients, 61.8% received reperfusion therapy: 30% with primary percutaneous coronary intervention (PPCI) and 31.8% with intravenous fibrinolysis (IF) (28.6% with pre-hospital thrombolysis). The median time from symptom onset to thrombolysis was 185 min and to PPCI was 358 min. In-hospital mortality was 5.3%. Compared with those managed at regional hospitals, patients managed at interventional university hospitals (n = 357) were more likely to receive reperfusion therapy (52.9% vs. 34.1%; p<0.001), with less IF (28.6% vs. 43.1%; p = 0.002) but more PPCI (37.8% vs. 3.9%; p<0.0001). However, in-hospital mortality in the two types of hospitals was similar (5.3% vs. 5.1%; p = 0.866).

Conclusions: Data from the FAST-MI Tunisia registry show that a pharmaco-invasive strategy of management for STEMI should be promoted in non-interventional regional hospitals.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Geographical map of participating centers.
Fig 1. Geographical map of participating centers.
1) Habib Bougatfa Hospital-Bizerte; 2) Menzel Bourguiba Hospital-Bizerte; 3) Abderrahmen Mami Hospital-Ariana; 4) Mongi Slim Hospital- Marsa-Tunis; 5) Military Hospital-Tunis; 6) Rabta Hospital-Tunis; 7) Jendouba Hospital-Jendouba; 8) M’hamed Bourguiba Hospital-Kef; 9) Sahloul Hospital-Sousse; 10) Farhat Hached Hospital-Sousse; 11) Fattouma Bourguiba Hospital-Monastir; 12) Ibn El Jazzar Hospital-Kairouan; 13) Hedi Chaker Hospital-Sfax; 14) Mohamed Ben Sassi Hospital- Gabes; 15) Habib Bourguiba Hospital-Medenine; 16) Ben Guerdene Hospital- Medenine.
Fig 2. Patients’ enrolment in different participating…
Fig 2. Patients’ enrolment in different participating centers.
A) University hospitals; B) Regional hospitals.

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