Abstract
IntroductionCurrent management and its impact on medium- or long-term prognosis of acute coronary syndrome (ACS) remain poorly studied in Middle East and North Africa.MethodsTOURACO is an ongoing observational prospective and longitudinal cohort study conducted in 8 countriesAlgeria, Bahrain, Egypt, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates. The main objective of the study is to evaluate the quality of care by assessing the treatment patterns of ACS in a real-life setting compared to International guidelines. Eligible patients were all patients hospitalized within the 24 hours of onset of symptoms of ACS (UA, NSTEMI or STEMI), having given written informed consent. Every site had a 6 - 12-month inclusion period. One-month follow-up data are reported here. Ongoing antiplatelet, cholesterol lowering agents, antihypertensive and drugs used in diabetes (as coded using WHO Drug dictionary) are compared to European Society of Cardiology (ESC) and American College of Cardiology (ACC) guidelines.ResultsForty-five sites included 1122 eligible patients (921 (82%) males) between December 2015 and February 2017 and 1108 (99%) patients were discharged. Treatment prescribed upon discharge (Table 1) complied with ESC and ACC guidelines in 835/1108 (74.4%) patients. In the first month following discharge, a thromboembolic event was reported in 16 (2%) patients. At one month, 903 (81%) patients were receiving 2 or more antiplatelet agents and 918 (83%) patients were receiving a cholesterol lowering agent. Overall 74% (n=824) patients were treated in accordance with the guidelinesthe percentage was 55%, 67% and 72% in the 465 diabetic, 571 hypertensive and 370 hypercholesterolemic patients respectively.ConclusionsOne month after ACS ¾ of patients were treated in compliance with ESC and ACC guidelines. The ongoing follow-up will allow to follow the evolution in the management of those patients.AcronymsTOURACOLong-Term follow-up and management patterns of patients with Acute Coronary Syndrome in Middle East and North AfricaClinicalTrials.gov IdentifierNCT03362463