Presentation, care, and outcomes of patients with NSTEMI according to World Bank country income classification

Background The majority of NSTEMI burden resides outside high-income countries (HICs). We describe presentation, care, and outcomes of NSTEMI by country income classification. Methods and results Prospective cohort study including 2947 patients with NSTEMI from 287 centres in 59 countries, stratified by World Bank country income classification. Quality of care was evaluated based on 12 guideline-recommended care interventions. The all-or-none scoring composite performance measure was used to define receipt of optimal care. Outcomes included in-hospital acute heart failure, stroke/transient ischaemic attack, and death, and 30-day mortality. Patients admitted with NSTEMI in low to lower-middle-income countries (LLMICs), compared with patients in HICs, were younger, more commonly diabetic, and current smokers, but with a lower burden of other comorbidities, and 76.7% met very high risk criteria for an immediate invasive strategy. Invasive coronary angiography use increased with ascending income classification (LLMICs, 79.2%

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DiRROS repository (University of Maribor)
Published
2026-03-23
Primary Topic
Acute Myocardial Infarction Research
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article
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article

Presentation, care, and outcomes of patients with NSTEMI according to World Bank country income classification

Yolande Appelman, A. Budaj, Maddalena Lettino, Kurt Huber et al.
DiRROS repository (University of Maribor)
Acute Myocardial Infarction Research
article

Presentation, care, and outcomes of patients with NSTEMI according to World Bank country income classification

Yolande Appelman, A. Budaj, Maddalena Lettino, Kurt Huber, Cécile Laroche, S. Leonardi, R Nadarajah, H Bueno, V Kunadian, Salvatore Brugaletta, Peter Ludman
article en

Abstract

Background The majority of NSTEMI burden resides outside high-income countries (HICs). We describe presentation, care, and outcomes of NSTEMI by country income classification. Methods and results Prospective cohort study including 2947 patients with NSTEMI from 287 centres in 59 countries, stratified by World Bank country income classification. Quality of care was evaluated based on 12 guideline-recommended care interventions. The all-or-none scoring composite performance measure was used to define receipt of optimal care. Outcomes included in-hospital acute heart failure, stroke/transient ischaemic attack, and death, and 30-day mortality. Patients admitted with NSTEMI in low to lower-middle-income countries (LLMICs), compared with patients in HICs, were younger, more commonly diabetic, and current smokers, but with a lower burden of other comorbidities, and 76.7% met very high risk criteria for an immediate invasive strategy. Invasive coronary angiography use increased with ascending income classification (LLMICs, 79.2%

DiRROS repository (University of Maribor)
Sigmund Freud Privatuniversität Wien (AT), Universidad Complutense de Madrid (ES), University of Leeds (GB), University of Pavia (IT), Leeds Teaching Hospitals NHS Trust (GB), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), Freeman Hospital (GB), Spanish National Centre for Cardiovascular Research (ES), European Society of Cardiology (FR), Wilhelminen Hospital (AT), Hospital Universitario 12 De Octubre (ES), Azienda Ospedaliera San Gerardo (IT), Hospital Clínic de Barcelona (ES), Policlinico San Matteo Fondazione (IT), Amsterdam University Medical Centers (NL), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Grochowski Hospital (PL), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), University of Birmingham (GB), Newcastle University (GB), Vrije Universiteit Amsterdam (NL)
Openalex Percentile: Top 3%
Acute Myocardial Infarction Research
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