Mohamed Sobhy, MD, Alexandria University, Alexandria, Egypt, shared updates from the Stent for Life Initiative (SFLI) in Egypt (www.stentforlifeegypt.com), reporting initial success in increasing the number of patients in the country with STEMI who are treated with primary percutaneous coronary intervention (PPCI).

Guidelines from the European Society of Cardiology (ESC), American College of Cardiology, and American Heart Association acknowledge PPCI as the method of choice to treat patients with STEMI, because it is superior in reducing morbidity and mortality, and improving quality of life, compared with any other treatment modality [Levine GN et al. J Am Coll Cardiol. 2011].

In Egypt, the SFLI is an international project conducted by the European Association of Percutaneous Cardiovascular Interventions of the ESC and EuroPCR, together with the Egyptian Society of Cardiology and the Egyptian Ministry of Health, which aims to generalize PPCI treatment in patients with acute STEMI.

Since enrolling in the SFLI in 2010, Egypt has been active in creating its professional organizational structure and developing and executing an action plan, prepared and enrolled by ICOM, to help improve the treatment of patients with cardiovascular diseases throughout the country. According to Prof Sobhy, access to PPCI has improved in Egypt since the program was implemented. The first step in the initiative was the launch of an online registry, the Egyptian SFLI registry [Stent for Life Egypt. http://www.stentforlife.com/2013/09/sfl-egypt-following-the-public-revolution-after-30-june/. Accessed September 24, 2014], to document the incidence of STEMI in Egypt and identify barriers to providing proper cardiovascular care to this patient population, which produced considerable results.

During the first phase of the registry (March 2011 to February 2012), 1877 patients were treated with PPCI. This increased to 2508 cases in the second phase (March 2011 to February 2013) and 3320 cases in the third phase (March 2013 to February 2014).

In addition, from 2011 to 2014, the number of catheterization laboratories across the country increased from 92 to 136, and the number of those that operate 24/7 has increased from 12 to 54. Simultaneously, the number of SFLI pilot centers has increased from 6 to 22 (Figure 1).

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Figure 1.

Trends in Availability of PPCI in Egypt From 2012 to 2014

Cath, catheterization; PPCI, primary percutaneous coronary intervention; SFLI, Stent for Life Initiative.Reproduced with permission from M Sobhy, MD.

In an effort to achieve its aims, Prof Sobhy said that education is an integral mission of all aspects of the SFLI in Egypt, focusing on physician educational meetings as well as patient awareness campaigns. Physician educational initiatives have comprised a combination of small-group SFLI satellite meetings in hospitals, as well as moderately sized group meetings (eg, InShape) and meetings of large groups involving international faculty at conferences. Educating physicians particularly about the importance of implementing diagnostic and therapeutic measures as quickly as possible is critical, he stressed.

Patient educational initiatives to date have included education days throughout Egypt, risk assessment surveys, and “Cycle for Your Heart” activity events, all aiming to educate patients about the country's SFLI. Patient informational flyers printed in Arabic are also available.

Prof Sobhy concluded that the next mission of the SFLI in Egypt for 2014 includes taking action specifically in neglected regions of the country, and implementing the “ACT NOW. SAVE A LIFE” campaign to improve public awareness of symptoms of heart attack so that they may seek emergency medical assistance quickly and receive lifesaving PPCI.