La tunisie Medicale - 2022 ; Vol 100 ( n°010 ) : 719-725
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Summary

Research problem : ST Elevation Myocardial Infarction (STEMI+) is an absolute emergency. The young age of patients and the difficulty of access to care remain the main characteristics of STEMI+ management in Tunisia. In the governorate of Béja, located in the Northwestern region of Tunisia, given the lack of a cardiology interventional room in the hospital and in the private establishments of the region and the distance from the specialized centers of at least 127 km, the patient is beyond 90 min of the transfer. This delay in care generates a heavy burden of morbidity and mortality. The main objective of this study will be to audit the delays of management of patients presenting STEMI+ at the regional hospital of Béja (Tunisia) in accordance with the recommendations of learned societies. Secondarily, we will identify factors associated with delayed presentation after the onset of clinical symptoms.
Investigation process : it will be a descriptive, exhaustive and prospective study, including patients admitted to the emergency and/or the cardiology department of the regional hospital of Béja for STEMI+ during the study period. For each patient admitted for STEMI, the following data will be collected : sociodemographic characteristics; medical history; cardiovascular risk factors; diagnostic and therapeutic management modalities; intra-hospital evolution; survival at 01 months in relation to the current coronary episode and the estimation of the different management delays.
Research plan : ethical considerations will be respected, as well as the confidentiality and anonymity of the data. The study will last one year from the 1st september 2022 to 31 august 2023. The results will allow us to describe the delays of management of patients with STEMI+ in the region of Béja (Tunisia). At least 2 publications in international scientific journals are planned.

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Reference
  1. Organisation Mondiale de la Santé (OMS). Maladies cardiovasculaires [Internet]. 2018 [cité 16 août 2022]. Disponible sur:https://www.who.int/fr/health-topics/cardiovascular-diseases.
  2. Ministère de Santé Publique, Institut National de la Santé. Statistiques nationales sur les causes de décès en Tunisie. 2015 et 2017. Tunis: MSP; 2020 p. 68.
  3. Moser DK, Kimble LP, Alberts MJ, Alonzo A, Croft JB, Dracup K, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council. Circulation. 2006;114(2):168‑82.
  4. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with STsegment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with STsegment elevation of the European Society of Cardiology (ESC). EurHeart J. 2018;39(2):119‑77.
  5. Dilali M, Aboulhassen T, Charrat H, Nejmi H. Syndrome coronarien aigu: quelle filière de soins au Maghreb? Urgences. 2013;38:35.
  6. Milouchi S, Ajmi H, Sghaeir A, Khorchani A, Ferjani S. ST elevation myocardial infarction therapeutic management in the regional hospital of Medenine, how to improve it? An analysis of 150 patients. Cardiologie Tunisienne. 2017;13(01):13‑6.
  7. Ministére de Santé Publique, Direction des études et de la planification. Carte sanitaire 2019. Tunis: MSP; 2021 p. 173.
  8. Puymirat E, Ducrocq G. Comparison between European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines for initial management of ST-elevation myocardial infarction (STEMI). Ann Cardiol Angeiol. 2013;62(4):265‑8.
  9. O’Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61(4):485‑510.
  10. Dubois P, Boland J, Vranckx P, et al. STEMI mortality in community hospitals versus PCI-capable hospitals: results from a nationwide STEMI network programme. Eur Heart J Acute Cardiovasc Care. 2012;1(1):40–7.
  11. Terkelsen CJ, Sorensen JT, Maeng M, Jensen LO, Tilsted HH, Trautner S, et al. System delay and mortality among patients with STEMI treated with primary percutaneous coronary intervention. JAMA. 2010;304(7):763–71.
  12. Yameogo NV, Samadoulougou A, Millogo G, Kologo KJ, Kombassere K, Toguyeni BJ, Zabsonre P. Delays in the management of acute coronary syndromes with ST-ST segment elevation in Ouagadougou and factors associated with an extension of these delays: a cross-sectional study about 43 cases collected in the CHU-Yalgado Ouédraogo. Pan Afr Med J. 2012;13:90.
  13. Moustaghfir, A., Haddak, M., & Mechmeche, R. (2012). Management of acute coronary syndromes in Maghreb countries: The ACCESS (ACute Coronary Events–a multinational Survey of current management Strategies) registry. Arch Cardiovasc Dis. 2012; 105(11), 566-77.
  14. Mehta S, Granger CB, Henry TD, Grines CL, Lansky A, Rokos I, Botelho R, Baumbach A, Mishra S, Cheem TH, Tresukosol D, Zambahari R, Ferré A, Castillo M. Reducing system delays in treatment of ST elevation myocardial infarction and confronting the challenges of late presentation in low and middle-income countries. Indian Heart J. 2017;69 Suppl 1(Suppl 1):S1-S5.
  15. Ba H, Yahia F, Wade A, et al. Quality of management of acute coronary syndrome at the Nouakchott National Heart Center (Mauritania). Tunis Med. 2019;97(12):1383-8.
  16. Yao H, Ekou A, Niamkey T, Hounhoui Gan S, Kouamé I, Afassinou Y et al. Acute Coronary Syndromes in Sub-Saharan Africa: A 10- Year Systematic Review. J Am Heart Assoc. 2022; 11(1), e021107.
  17. Addad F, Mahdhaoui A, Gouider J, Boughzela E, Kamoun S, Boujnah MR, et al. Management of patients with acute STelevation myocardial infarction: Results of the FAST-MI Tunisia Registry. PLoS ONE. 2019; 14(2): e0207979.
  18. Menees DS, Peterson ED, Wang Y, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med. 2013;369:901-9.
  19. Koul S, Andell P, Martinsson A, et al. Delay from first medical contact to primary PCI and all-cause mortality: a nationwide study of patients with ST-elevation myocardial infarction. J Am Heart Assoc. 2014;3, e000486.
  20. Rangé G, Saint Etienne C, Marcollet P, Chassaing S, Dequenne P, Hakim R et al. Factors associated with delay in transfer of patients with ST-segment elevation myocardial infarction from first medical contact to catheterization laboratory: Lessons from CRAC, a French prospective multicentre registry. Arch Cardiovasc Dis. 2019; 112(1), 3-11.
  21. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S1533.
  22. Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227337.
  23. Kakou-Guikahue M, N’Guetta R, Anzouan-Kacou JB, Kramoh E, N’Dori R, Ba SA et al.Optimizing the management of acute coronary syndromes in sub-Saharan Africa: A statement from the AFRICARDIO 2015 Consensus Team. Arch Cardiovasc Dis. 2016;109(6-7):376-383.
  24. Mehta S, Granger CB, Henry TD, Grines CL, Lansky A, Rokos I, et al. Reducing system delays in treatment of ST elevation myocardial infarction and confronting the challenges of late presentation in low and middle-income countries. Indian Heart J. 2017;69 (Suppl 1):S1-S5.
  25. Loirat M, Orion L, Fradin P, Dimet J, Boiffard E. Reperfusion delays in acute coronary syndromes with ST segment elevation (STEMI) depending on prehospital care. Ann Cardiol Angeiol. 2013;62(5):287‑92.
  26. Serhier Z, Bendahhou K, Ben Abdelaziz A, Bennani MO. Methodological sheet n°1: How to calculate the size of a sample for an observational study? Tunis Med. 2020;98(1):1-7.
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