Tern, Paul Jie Wen and Ho, Aaron Kwun Hang and Sultana, Rehena and Ahn, Youngkeun and Almahmeed, Wael and Brieger, David and Chew, Derek P. and Fong, Alan Yean Yip and Hwang, Jinyong and Kim, Yongcheol and Komuro, Issei and Maemura, Koji and Mohd-Ali, Rosli and Quek, David Kwang Leng and Reid, Christopher and Tan, Jack Wei Chieh and Wan Ahmad, Wan Azman and Yasuda, Satoshi and Yeo, Khung Keong (2021) Comparative overview of ST-elevation myocardial infarction epidemiology, demographics, management, and outcomes in five Asia-Pacific countries: a meta-analysis. European Heart Journal-Quality of Care and Clinical Outcomes, 7 (1). pp. 6-17. ISSN 2058-5225, DOI https://doi.org/10.1093/ehjqcco/qcaa057.
Full text not available from this repository.Abstract
The aim of this study is to gain insight into the differences in demographics of ST-elevation myocardial infarction (STEMI) patients in Asia-Pacific, as well as inter-country variation in treatment and mortality outcomes. Systematic review of published studies and reports from known registries in Australia, Japan, Korea, Singapore, and Malaysia that began data collection after the year 2000. Supplementary self-report survey questionnaire on public health data answered by representative cardiologists working in these countries. Twenty studies comprising of 158 420 patients were included in the meta-analysis. The mean age was 61.6 years. Chronic kidney disease prevalence was higher in Japan, while dyslipidaemia was low in Korea. Use of aspirin, P2Y(12) inhibitors, and statins were high throughout, but ACEi/ARB and beta-blocker prescriptions were lower in Japan and Malaysia. Reperfusion strategies varied greatly, with high rates of primary percutaneous coronary intervention (pPCI) in Korea (91.6%), whilst Malaysia relies far more on fibrinolysis (72.6%) than pPCI (9.6%). Similarly, mortality differed, with 1-year mortality from STEMI was considerably greater in Malaysia (17.9%) and Singapore (11.2%) than in Korea (8.1%), Australia (7.8%), and Japan (6.2%). The countries were broadly similar in development and public health indices. Singapore has the highest gross national income and total healthcare expenditure per capita, whilst Malaysia has the lowest. Primary PCI is available in all countries 24/7/365. Despite broadly comparable public health systems, differences exist in patient profile, in-hospital treatment, and mortality outcomes in these five countries. Our study reveals areas for improvements. The authors advocate further registry-based multicountry comparative studies focused on the Asia-Pacific region.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | STEMI; Systematic review; Demographics; Treatment; Mortality; Asia-Pacific |
| Subjects: | R Medicine > RC Internal medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 08 Jul 2022 03:43 |
| Last Modified: | 08 Jul 2022 03:43 |
| URI: | http://eprints.um.edu.my/id/eprint/34667 |
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