STEMI remains a major cause of morbidity, mortality, disability, and high health care costs in Latin America and the rest of the world. New data assessing the impact of ACC's Global Heart Attack Initiative (GHATI) on patient care outcomes at the CEDIMAT Cardiovascular Center in Santo Domingo, Dominican Republic, suggest that a larger-scale quality improvement initiative aimed at addressing barriers to timely reperfusion and adherence to evidence-based care could help to mitigate these trends in low- to middle-income countries (LMICs).

Researchers, who presented their findings as part of ACC Latin American 2024, analyzed data from 318 patients presenting with STEMI between January 2015 and 2024. Patients were categorized into three periods: P1 from 2015-2019; P2 from 2020-2022; and P3 from 2023 onwards. Of the patients, 70% were male and the average age was 63 years.

Results from the study showed an increase from 91% in P1 to 100% in P3 in the proportion of patients receiving aspirin and P2Y12 inhibitors between first medical contact and reperfusion therapy. Evaluation of left ventricular ejection fraction (LVEF) also increased from 95% to 100% in the same period. Beta-blockers and statins at discharge, as well as the prescription of aspirin and P2Y12 inhibitors and ACE-1 or ARBs for left ventricular systolic dysfunction at discharge, also increased across the three periods (92% to 100%; 86% to 96%; 88% to 96%; and 93% to 100%, respectively).

"Taking into consideration the impact of the pandemic, the evolution of this STEMI program enrolled in ACC's GHATI registry demonstrated sustained improvement in quality metrics," said Samuel Gabino Guzman, MD; Carlos Garcia Lithgow, MD, FACC; et al. "If confirmed in a regional larger scale, this experience may be useful when addressing barriers to timely reperfusion and adherence to guideline-based therapies in LMICs."