Mohamed Sobhy1, Mohammed Arafah2, Mohamed Elsayed3, Jassim Al Suwaidi4, Fahad Baslaib5, Djamaleddine Nibouche6, Hany Ragy7, Adel Rhouati8, Nooshin Bazargani9, Ramez Guindy10
1International Cardiac Center Hospital, Alexandria, Egypt, 2King Saud University, Riyadh, Saudi Arabia, 3AstraZeneca, Luton and Dubai, United Kingdom, 4Hamad Medical Corporation, Doha, Qatar, 5Rashid Hospital, Dubai, United Arab Emirates, 6CHU Hussein-Dey, Algiers, Algeria, 7, Cairo8, Constantine, Dubai
The TOURACO study aimed at evaluating ACS quality of care in the Middle East and North Africa by assessing the treatment patterns compared to 2012’s European Society of Cardiology (ESC) and 2000’s American College of Cardiology (ACC) guidelines, in a real-life setting.
TOURACO is an observational prospective study on adults hospitalized within 24 hours of ACS onset and having given written informed consent, in Algeria, Bahrain, Egypt, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Ongoing antiplatelet and antihypertensive drugs, cholesterol- and glucose-lowering agents were recorded at 6-month and 1-year follow-up visits after hospital discharge.
Between December 2015 and February 2017, 1,124 eligible patients (mean age: 56±11 years; 912 (82.1%) males; median body mass index: 27.1 [24.0; 30.4] kg/m2) were included; 603 (53.6%) patients had a STEMI, 300 (26.7%) patients a NSTEMI and 222 (19.8%) patients an unstable angina. A 6-month visit was documented in 911 (82.0%) patients; at 1 year, some data were available for 972 (87.5%) patients including detailed ongoing treatment in 387 patients. One year after discharge, 26 (2.5%) patients had died and 29% are still followed in the same hospital.
At 6-months, 862 (77.6%) patients were receiving an antithrombotic treatment, 804 (72.4%) patients ≥2 antiplatelets, 835 (75.2%) patients a cholesterol-lowering treatment, 241 (21.7%) patients a glucose lowering agents and 834 (75.1%) patients an antihypertensive drug treatment. At 1-year, 940 (96.7%) patients continued treatments prescribed at discharge.
Compliance with guidelines is shown Table 1.
Six months and 1 year after ACS, 8/10 of patients were treated in compliance with ESC and ACC guidelines but was lower in diabetic patients.