Outcomes of Acute Coronary Syndromes in Iran:A Systematic Review

Objective: To systematically review ACS care in developing countries in the Middle East, Africa, and Southeast Asia.Methods: We performed searches on PubMed and Embase for studies published between 1990 and 2017 related to ACS care in Iran including STEMI, thrombolytic and PCI rates, and in-hospital mortality. Our Pubmed keywords included Iran, ACS, and myocardial infarction . Studies with more than 30 patients that included STEMI and NSTEMI patients or STEMI patients alone were included in the study. We found 82 studies.Results: Five studies met inclusion criteria including 2,189 patients (913 with STEMI). Most patients were male (62-96%) and were 40-60 years old at presentation. The proportion of patients presenting with a STEMI ranged from 26.8-70.1%. Many cardiology centers did not offer primary PCI with rates of primary reperfusion. The percentage of patients using EMS transport remained under 15%. Cities with smaller hospitals tended to have fewer STEMI patients undergoing reperfusion with thrombolysis [Correlation coefficient: -0.42 (95% CI -0.87, 0.08), p= 0.014].Conclusion: Using emergency medical facilities, primary PCI for STEMI and thrombolysis is low in Iran likely secondary to underdeveloped infrastructure and lack of resources underdeveloped infrastructure. Further study is required to understand factors that can be targeted for quality improvement efforts.

کلیدواژه ها:

Iran ، Acute coronary syndrome ، Cardiology ، Myocardial infarction