A collaborative effort across Africa to investigate risk factors and outcomes of premature acute coronary syndrome: Protocol for the EAS Lipid Registry of Africa (LIPRA)

doi:10.1016/j.athplu.2024.10.002

. 2024 Oct 24:58:46-50.

doi: 10.1016/j.athplu.2024.10.002. eCollection 2024 Dec.

A collaborative effort across Africa to investigate risk factors and outcomes of premature acute coronary syndrome: Protocol for the EAS Lipid Registry of Africa (LIPRA)

Ashraf Reda^{1

2}, Alexander R M Lyons³, Alberto Zambon^{4

5}, Ahmed Bendary⁶, Mutaz Al-Khnifsawi^{7

8}, Habib Gamra⁹, David Marais¹⁰, Okechukwu S Ogah¹¹, Tigist Seleshi¹², Ahmed A A Suliman¹³, Julius C Mwita¹⁴, Albertino Damasceno^{15

16}, Anastase Dzudie^{17

18}, Atef Elbahry^{19

2}, Elsayed Farag^{20

2}, Chala Fekadu¹², Lilian Mbau²¹, Mohammed Mujahed²², Rosemary P Minja²³, Bernard Samia^{24

25}, Mahmoud Sani²⁶, Lambert T Appiah^{27

28}, Alexandros Tselepis²⁹; EAS Lipid Registry of Africa Investigators

Affiliations

¹ Cardiology Department, College of Medicine, Menofia University, Shibin Al Kawm, Al Minufiyah, Egypt.
² Egyptian Association of Vascular Biology and Atherosclerosis, Egypt.
³ Freelance Consultancy on behalf of European Atherosclerosis Society, Gothenburg, Sweden.
⁴ Department of Medicine, University of Padua School of Medicine, Italy.
⁵ Division of Endocrinology, Metabolism and Nutrition, School of Medicine, University of Washington, Seattle, WA, USA.
⁶ Cardiology Department, Benha Faculty of Medicine, Benha University, Egypt.
⁷ University of Warith Al-Anbiyaa, College of Medicine, Karbala, Iraq.
⁸ University of Al-Qadisiyah, College of Pharmacy, Diwaniyah, Iraq.
⁹ Faculty of Medicine and University of Monastir, Tunisia.
¹⁰ Division of Chemical Pathology, Department of Pathology, Health Science Faculty, University of Cape Town, Cape Town, Western Cape Province, South Africa.
¹¹ Cardiology Unit, Department of Medicine, University of Ibadan, University College Hospital, Ibadan, Oyo state, Nigeria.
¹² Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
¹³ Department of Medicine, Faculty of Medicine, University of Khartoum, Sudan.
¹⁴ Department of Internal Medicine, University of Botswana and Princess Marina Hospital, Gaborone, Botswana.
¹⁵ Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
¹⁶ Research Unit, Department of Medicine, Maputo Central Hospital, Maputo, Mozambique.
¹⁷ Service of Cardiovascular Medicine and Subspecialties, Douala General Hospital, Douala, Cameroon.
¹⁸ Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
¹⁹ Heart Centre Port-Fouad, Port-Said, Egypt.
²⁰ Zagazig University, Egypt.
²¹ Centre for Cardiovascular Disease Prevention and Rehabilitation, Nairobi, Kenya.
²² Sudan Lipid Clinic, Khartoum, Sudan.
²³ Department of Internal Medicine, Muhimbili National Hospital, Mloganzila, Tanzania.
²⁴ MP Shah Hospital, Nairobi, Kenya.
²⁵ Kenya Cardiac Society, Kenya.
²⁶ Department of Medicine, Bayero University Kano & Aminu Kano Teaching Hospital, Kano, Nigeria.
²⁷ School of Medical Sciences (KNUST-SMS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
²⁸ University of Amsterdam Medical Center, Amsterdam UMC, the Netherlands.
²⁹ University of Ioannina, Ioannina, Greece.

PMID: 39534786
PMCID: PMC11555408
DOI: 10.1016/j.athplu.2024.10.002

A collaborative effort across Africa to investigate risk factors and outcomes of premature acute coronary syndrome: Protocol for the EAS Lipid Registry of Africa (LIPRA)

Ashraf Reda et al. Atheroscler Plus. 2024.

. 2024 Oct 24:58:46-50.

doi: 10.1016/j.athplu.2024.10.002. eCollection 2024 Dec.

Authors

Affiliations

¹ Cardiology Department, College of Medicine, Menofia University, Shibin Al Kawm, Al Minufiyah, Egypt.
² Egyptian Association of Vascular Biology and Atherosclerosis, Egypt.
³ Freelance Consultancy on behalf of European Atherosclerosis Society, Gothenburg, Sweden.
⁴ Department of Medicine, University of Padua School of Medicine, Italy.
⁵ Division of Endocrinology, Metabolism and Nutrition, School of Medicine, University of Washington, Seattle, WA, USA.
⁶ Cardiology Department, Benha Faculty of Medicine, Benha University, Egypt.
⁷ University of Warith Al-Anbiyaa, College of Medicine, Karbala, Iraq.
⁸ University of Al-Qadisiyah, College of Pharmacy, Diwaniyah, Iraq.
⁹ Faculty of Medicine and University of Monastir, Tunisia.
¹⁰ Division of Chemical Pathology, Department of Pathology, Health Science Faculty, University of Cape Town, Cape Town, Western Cape Province, South Africa.
¹¹ Cardiology Unit, Department of Medicine, University of Ibadan, University College Hospital, Ibadan, Oyo state, Nigeria.
¹² Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
¹³ Department of Medicine, Faculty of Medicine, University of Khartoum, Sudan.
¹⁴ Department of Internal Medicine, University of Botswana and Princess Marina Hospital, Gaborone, Botswana.
¹⁵ Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
¹⁶ Research Unit, Department of Medicine, Maputo Central Hospital, Maputo, Mozambique.
¹⁷ Service of Cardiovascular Medicine and Subspecialties, Douala General Hospital, Douala, Cameroon.
¹⁸ Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
¹⁹ Heart Centre Port-Fouad, Port-Said, Egypt.
²⁰ Zagazig University, Egypt.
²¹ Centre for Cardiovascular Disease Prevention and Rehabilitation, Nairobi, Kenya.
²² Sudan Lipid Clinic, Khartoum, Sudan.
²³ Department of Internal Medicine, Muhimbili National Hospital, Mloganzila, Tanzania.
²⁴ MP Shah Hospital, Nairobi, Kenya.
²⁵ Kenya Cardiac Society, Kenya.
²⁶ Department of Medicine, Bayero University Kano & Aminu Kano Teaching Hospital, Kano, Nigeria.
²⁷ School of Medical Sciences (KNUST-SMS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
²⁸ University of Amsterdam Medical Center, Amsterdam UMC, the Netherlands.
²⁹ University of Ioannina, Ioannina, Greece.

PMID: 39534786
PMCID: PMC11555408
DOI: 10.1016/j.athplu.2024.10.002

Abstract

Data on acute coronary syndrome (ACS) is lacking in Africa where cases of premature ACS seem to be on the rise. Africa would benefit from an epidemiological assessment of premature ACS to determine its risk factors and management in this demographic to inform guidelines and practice. The European Atherosclerosis Society recognised this urgency and formed a growing network across 11 African countries to create the Lipid Registry of Africa (EAS-LIPRA). This article is based on the EAS-LIPRA protocol and presents the aims, concept and methodological considerations, and the operations and collaborative governance structure of this project. EAS-LIPRA aims to report risk factors and outcomes of premature ACS in Africa to further understand its prevalence and management via collating and pooling multinational prospective data on premature ACS across multiple sites in Africa into a standardised registry. Data will be stratified into subgroups based on country-level income as defined by the World Bank, and within country residence of urban versus rural areas. Valid statistical procedures will be employed to compare and observe trends in the pooled data based on demographics, clinical and laboratory variables, and disparities in its management. Being the first multinational lipid registry in Africa, it is envisaged that the network will expand to other African countries and sites yet to participate, facilitate other epidemiological studies in preventive cardiology, and set a precedent for other developing countries and regions.

Keywords: Acute coronary syndrome; Cardiovascular disease risk; Coronary artery disease; EAS LIPRA; NSTEMI; Premature acute coronary syndrome; STEMI; Unstable angina.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Fig. 1**
EAS-LIPRA collaborative governance structure.

See this image and copyright information in PMC

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[1] Byrne R.A., Rossello X., Coughlan J.J., Barbato E., Berry C., Chieffo A., Claeys M.J., Dan G.A., Dweck M.R., Galbraith M., Gilard M., Hinterbuchner L., Jankowska E.A., Jüni P., Kimura T., Kunadian V., Leosdottir M., Lorusso R., Pedretti R.F.E., Rigopoulos A.G., Rubini Gimenez M., Thiele H., Vranckx P., Wassmann S., Wenger N.K., Ibanez B., ESC Scientific Document Group 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720–3826. doi: 10.1093/eurheartj/ehad191. - DOI - PubMed

[2] Byrne R.A., Rossello X., Coughlan J.J., Barbato E., Berry C., Chieffo A., Claeys M.J., Dan G.A., Dweck M.R., Galbraith M., Gilard M., Hinterbuchner L., Jankowska E.A., Jüni P., Kimura T., Kunadian V., Leosdottir M., Lorusso R., Pedretti R.F.E., Rigopoulos A.G., Rubini Gimenez M., Thiele H., Vranckx P., Wassmann S., Wenger N.K., Ibanez B., ESC Scientific Document Group 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720–3826. doi: 10.1093/eurheartj/ehad191. - DOI - PubMed

[3] Libby P., Pasterkamp G., Crea F., Jang I.K. Reassessing the mechanisms of acute coronary syndromes. Circ Res. 2019;124(1):150–160. doi: 10.1161/CIRCRESAHA.118.311098. - DOI - PMC - PubMed

[4] Libby P., Pasterkamp G., Crea F., Jang I.K. Reassessing the mechanisms of acute coronary syndromes. Circ Res. 2019;124(1):150–160. doi: 10.1161/CIRCRESAHA.118.311098. - DOI - PMC - PubMed

[5] Reda A., Ashraf M., Soliman M., Ragy H., El Kersh A., Abdou W., Mostafa T., Hassan M., Farag E., Khamis H., Wadie M., Elbahry A., Salama S., Kazamel G., Sadaka M., Mostafa M., Abd El-Bary A., Sanad O., Rafla S., Abd El-Hady Y., Selim M., Farag N., El-Ghawaby H., El-Araby H., Emil S., Beshay M., Shawky A., Yusef M., Abd El-Ghany M., Gamal A., Baghdady Y., Mostafa T., Zahran M., El Rabat K., Bendary A., El Shorbagy A. The pattern of risk-factor profile in Egyptian patients with acute coronary syndrome: phase II of the Egyptian cross-sectional CardioRisk project. Cardiovasc J Afr. 2019;30(2):87–94. doi: 10.5830/CVJA-2018-074. - DOI - PubMed

[6] Reda A., Ashraf M., Soliman M., Ragy H., El Kersh A., Abdou W., Mostafa T., Hassan M., Farag E., Khamis H., Wadie M., Elbahry A., Salama S., Kazamel G., Sadaka M., Mostafa M., Abd El-Bary A., Sanad O., Rafla S., Abd El-Hady Y., Selim M., Farag N., El-Ghawaby H., El-Araby H., Emil S., Beshay M., Shawky A., Yusef M., Abd El-Ghany M., Gamal A., Baghdady Y., Mostafa T., Zahran M., El Rabat K., Bendary A., El Shorbagy A. The pattern of risk-factor profile in Egyptian patients with acute coronary syndrome: phase II of the Egyptian cross-sectional CardioRisk project. Cardiovasc J Afr. 2019;30(2):87–94. doi: 10.5830/CVJA-2018-074. - DOI - PubMed

[7] Menezes Fernandes R., Mota T., Costa H., Bispo J., Azevedo P., Bento D., Guedes J., Carvalho D., Marques N., Santos W., Mimoso J., de Jesus I. Portuguese Registry of Acute Coronary Syndromes (ProACS) investigators. Premature acute coronary syndrome: understanding the early onset. Coron Artery Dis. 2022;33(6):456–464. doi: 10.1097/MCA.0000000000001141. - DOI - PubMed

[8] Menezes Fernandes R., Mota T., Costa H., Bispo J., Azevedo P., Bento D., Guedes J., Carvalho D., Marques N., Santos W., Mimoso J., de Jesus I. Portuguese Registry of Acute Coronary Syndromes (ProACS) investigators. Premature acute coronary syndrome: understanding the early onset. Coron Artery Dis. 2022;33(6):456–464. doi: 10.1097/MCA.0000000000001141. - DOI - PubMed

[9] Fox K.A., Eagle K.A., Gore J.M., Steg P.G., Anderson F.A. GRACE and GRACE2 investigators. The global registry of acute coronary events, 1999 to 2009 – grace. Heart. 2010;96(14):1095–1101. doi: 10.1136/hrt.2009.190827. - DOI - PubMed

[10] Fox K.A., Eagle K.A., Gore J.M., Steg P.G., Anderson F.A. GRACE and GRACE2 investigators. The global registry of acute coronary events, 1999 to 2009 – grace. Heart. 2010;96(14):1095–1101. doi: 10.1136/hrt.2009.190827. - DOI - PubMed

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A collaborative effort across Africa to investigate risk factors and outcomes of premature acute coronary syndrome: Protocol for the EAS Lipid Registry of Africa (LIPRA)

Affiliations

A collaborative effort across Africa to investigate risk factors and outcomes of premature acute coronary syndrome: Protocol for the EAS Lipid Registry of Africa (LIPRA)

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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References

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Abstract

Conflict of interest statement

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