Egyptian Cardiovascular Risk Factors Project
Egyptian Association of Vascular Biology and Atherosclerosis
Egyptian CardioRisk Board
Background and Rationale
The observed increase in the numbers of patients admitted with acute coronary syndromes (ACS), all over the world as well as in the middle – east, has raised many questions about the precipitating factors and etiological background. Epidemiological data have shown the importance of traditional and other risk factors in the pathogenesis of atherosclerosis. Recent studies, however suggest that the pattern of risk factor profile may differ according to age, gender as well as racial and geographical factors. The study of such data in our region may demonstrate the proper risk profile of our patients, and could be an appropriate database allowing the initiation of national guidelines.
The acute coronary syndromes include a variety of clinical scenarios ranging from unstable angina and myocardial infarction without persistent-ST-segment elevation to myocardial infarction with persistent-ST segment elevation. A plethora of new pharmacological and technical approaches to acute coronary syndromes has been ushered into clinical practice in recent years. This has resulted in a significant heterogeneity in the management and treatment of patients with acute coronary syndromes. The current study would mainly be concerned with the risk factors profile in such groups of patients with proven ischemic heart disease, and with information about the medical and interventional management strategies in different cardiac centers in Egypt.
The diagnostic criteria and major treatment strategies, including reperfusion therapy, for ST-segment elevation myocardial infarction, are well-defined. However, acute coronary syndromes without ST-segment elevation (unstable angina and non-Q wave myocardial infarction) are more heterogeneous and have greater variation in diagnostic criteria and treatment. The prevalence of recognized unstable angina appears to be increasing and data
from North America suggest that it is now more common than acute myocardial infarction.
Disparities in cardiovascular and other health outcomes across geographical regions are common, and yet not well understood. Significant variations in clinical outcomes often persist in acute coronary syndrome (ACS) patients. Although some studies have not shown mortality differences in either ST segment elevation or non- ST segment elevation ACS patients, others have reported better quality of life and mortality outcomes in countries with high revascularizations rates. Such disparities in outcomes provide incentives to further investigations of the underlying factors, including risk profile, demographic changes, including aging of the population, as well as the implication of the positive finding of recent pharmacological trials on the treatment strategies.
Epidemiological surveys provide a useful means of identifying variations in clinical practice and their effect on outcomes. During the past decades, epidemiological investigations have provided a portrait of the potential candidate for acute coronary syndromes, in the US, as well as in many other parts of the world, especially in European countries. However, many investigators claimed for differences in the profile, i.e. socio-demographic characteristics, prevalence of risk factors, dietary habits, etc. of people who suffer from coronary heart disease, between populations as well as among individuals within populations