20.500.12556/DiRROS-28490 Presentation, care, and outcomes of patients with NSTEMI according to World Bank country income classification the ACVC-EAPCI EORP NSTEMI Registry of the European Society of Cardiology 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%; upper middle income countries [UMICs], 83.7%; HICs, 91.0%), but overall care quality did not (≥80% of eligible interventions achieved: LLMICS, 64.8%; UMICs 69.6%; HICs 55.1%). Rates of acute heart failure (LLMICS, 21.3%; UMICs, 12.1%; HICs, 6.8%; P < 0.001), stroke/transient ischaemic attack (LLMICS: 2.5%; UMICs: 1.5%; HICs: 0.9%; P = 0.04), in-hospital mortality (LLMICS, 3.6%; UMICs: 2.8%; HICs: 1.0%; P < 0.001) and 30-day mortality (LLMICs, 4.9%; UMICs, 3.9%; HICs, 1.5%; P < 0.001) exhibited an inverse economic gradient. Conclusion Patients with NSTEMI in LLMICs present with fewer comorbidities but a more advanced stage of acute disease, and have worse outcomes compared with HICs. A cardiovascular health narrative is needed to address this inequity across economic boundaries. country income mortality NSTEMI quality indicators registry državni dohodek smrtnost NSTEMI kazalniki kakovosti register true false true Angleški jezik Slovenski jezik Neznano 2026-03-23 09:30:23 2026-03-23 09:30:23 2026-03-26 03:58:10 0000-00-00 00:00:00 2023 0 0 Nasl. z nasl. zaslona; Opis vira z dne 16. 3. 2026; str. 552–563 issue 6 Vol. 9 2023 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.127-005.8 2058-1742 10.1093/ehjqcco/qcad008 271806211 RAZ_Nadarajah_Ramesh_2023.pdf RAZ_Nadarajah_Ramesh_2023.pdf 1 90FA528BF0B433B071BC496DAE7224D4 2d29ad9a1cc6cac267d05803de8ec8ea580d7f13d83e32dc0edd97689e985973 c9fb01b1-2692-11f1-aa40-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42239 https://academic.oup.com/ehjqcco/article/9/6/552/7025946 1 8d656c73-2692-11f1-aa40-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42238 Univerzitetni klinični center Ljubljana 0 0 0