Academic Journal
Applicability of ischemic heart disease clinical practice guidelines in low- and middle-income countries.
| Τίτλος: | Applicability of ischemic heart disease clinical practice guidelines in low- and middle-income countries. |
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| Συγγραφείς: | Ambrosio G; National Institute for Cardiovascular Research - INRC, Bologna, Italy., Gowdak LHW; Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil., Weiskopf RB; University of California, San Francisco, San Francisco, CA, USA; Translational Medicine Academy, Basel, Switzerland. Electronic address: RBW@TheWeiskopfGroup.com., Zieroth S; Section of Cardiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada., Anker SD; Department of Cardiology (CVK) of German Heart Center Charité; German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany., Abraham WT; Division of Cardiovascular Medicine, The Ohio State University College of Medicine, Columbus, OH, USA., Atherton JJ; Department of Cardiology, Royal Brisbane and Women's Hospital and University of Queensland Faculty of Health, Medicine, and Behavioural Sciences, Brisbane, QLD, Australia., Butler J; Baylor Scott and White Research Institute, Dallas, TX and University of Mississippi, Jackson, MS, USA., Chopra V; Max Super Specialty Hospital, New Delhi, India., Coats AJS; Heart Research Institute, The University of Sydney, Sydney, NSW, Australia., Dean V; Translational Medicine Academy, Basel, Switzerland., Filippatos G; National and Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon, Athens, Greece., Fudim M; Duke University Medical Center, Durham, North Carolina, USA., Gamra H; Faculty of Medicine, University of Monastir, Tunisia., Zamorano JL; Department of Cardiology, University Hospital Ramón y Cajal, CIBERCV, Madrid, Spain., Zhang Y; Peking Union Medical College, Beijing, China., Colardelle Y; Translational Medicine Academy, Basel, Switzerland., Gulati M; The Davis Women's Heart Center, Department of Cardiology, DeBakey Heart and Vascular Center, Houston Methodist, Houston, USA., Pinto F; Faculdade de Medicina da Universidade de Lisboa, CCUL@RISE, Lisbon, Portugal. |
| Πηγή: | International journal of cardiology [Int J Cardiol] 2026 Oct 15; Vol. 461, pp. 134637. Date of Electronic Publication: 2026 Jul 01. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8200291 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1874-1754 (Electronic) Linking ISSN: 01675273 NLM ISO Abbreviation: Int J Cardiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam : Elsevier Original Publication: Amsterdam : Elsevier/North-Holland Biomedical Press, c1981- |
| Ιατρικοί όροι (MeSH): | Myocardial Ischemia*/therapy , Myocardial Ischemia*/economics , Myocardial Ischemia*/diagnosis , Myocardial Ischemia*/epidemiology , Developing Countries*/economics , Practice Guidelines as Topic*/standards , Guideline Adherence*/economics , Guideline Adherence*/standards , Practice Patterns, Physicians'*/standards , Practice Patterns, Physicians'*/economics, Humans ; Female ; Surveys and Questionnaires ; Male ; Resource-Limited Settings |
| Περίληψη: | Background: Ischemic heart disease (IHD) presents a growing global health burden across diverse geographic and socioeconomic settings. Clinical practice guidelines are typically developed by professional societies in high-income countries, often with limited consideration of implementation barriers in other healthcare settings. We sought to understand clinicians' use of IHD guidelines in their practice, perceived deficiencies, implementation barriers, and differences between doctors practicing in high-income countries (HIC) or in low-/middle-income countries (LMIC). Methods: An internet-based, international survey of physicians treating patients with IHD, (July 26, 2025-November 15, 2025), inquiring about participants' demographics, experience, and views of IHD guidelines as related to their practice. Results: Responses were provided by 587 clinicians from 97 countries. Approximately half (51.8%) considered the IHD guidelines as mostly or fully applicable in their country, a view more preponderant in HIC (67.3%) than in LMIC (48.8%; p = 0.0125). Most (63.2%) thought IHD guidelines were highly applicable in HIC, but only 9.0% deemed the same for LMIC. The greatest barriers to guideline implementation were their being mostly relevant for HIC (72%), and cost, with the latter selected more frequently by the LMIC than the HIC group (61.7% v 20.4%; p < 0.00001). Desires for future guidelines included availability in digital format, and inclusion of co-authors from LMIC. Conclusions: Survey respondents indicated that current IHD guidelines do not address the needs of clinicians and patients in LMIC as effectively as they do for those in HIC. Respondents advocated for future guidelines to have specific recommendations for differing socio-economic environments, and consideration of cost reimbursement. (Copyright © 2026. Published by Elsevier B.V.) |
| Competing Interests: | Declaration of competing interest Please note that these are given with a broad consideration; however, neither the questions of the survey mentioned or inquired, nor does the manuscript describe or discuss any pharmaceuticals or devices that might be manufactured or sold by any company including those listed below. RBW, JJA, AJSC, YZ, VD, YC: None. GA: Speaking honoraria and consulting fees from: Amarin, CLS, Menarina, Novo Nordisk. LHWG: Speaking honoraria from Servier, Novartis, GSK. MG: Reports Serving on a data safety monitoring board for an investigational lipid lowering product for Merck. Serves as a consultant for Amgen, Bayer and Boehringer Ingelheim and Pfizer. GF: reports lecture fees and/or advisory and/or trial committee membership by Bayer, Boehringer Ingelheim, Servier, Novartis, Impulse Dynamics, Vifor, Medtronic, MSD, Cardior, Novo Nordisk and Research Grants from the European Union. SZ: has served on advisory boards or speaker engagements with AskBio, Abbott, Alnylam, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, CSL Vifor, Cytokinetics, Eli Lilly, GSK, Medtronic, Merck, Novartis, Novo-Nordisk, SunPharma, Pfizer, Viatris and serves on a clinical trial committee for studies sponsored by AstraZeneca, Boehringer Ingelheim, Cardiac Dimensions, Cytokinetics, Merck, Novo Nordisk, Pfizer, Salubris Bio. Non industry: CCS, CHFS, Charite, CPD Network, CSN, EOCI, iHF, Liv, LMC Healthcare, Medscape, Medudy, Radcliffe, Reach MD, Sciarc, Translational Medicine Academy. HG: lecturing and consultancy honoraria from Astra Zeneca, Servier and Menarini. SDA: Grants and personal fees from Vifor and Abbott Vascular, and personal fees for consultancies, trial committee work and/or lectures from Actimed, Amgen, Astra Zeneca, Bayer, Boehringer Ingelheim, Brahms, Cardiac Dimensions, Cardior, Cordio, CVRx, Cytokinetics, Edwards, Farraday Pharmaceuticals, GSK, HeartKinetics, Impulse Dynamics, Occlutech, Pfizer, Regeneron, Repairon, Scirent, Sensible Medical, Servier, Vectorious, and V-Wave. Named co-inventor of two patent applications regarding MR-proANP (DE 102007010834 & DE 102007022367), but he does not benefit personally from the related issued patents. FP: Speaker fees, advisory board:AstraZeneca, Abbott, Boehringer-Ingelheim, Medtronic, Novartis, Philips, Servier, Vifor. JB: Consultant to Abbott, American Regent, Amgen, Applied Therapeutic, AskBio, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardiac Dimension, Cardiocell, Cardior, CSL Bearing, CVRx, Cytokinetics, Daxor, Edwards, Element Science, Faraday, Foundry, G3P, Innolife, Impulse Dynamics, Imbria, Inventiva, Ionis, Lexicon, Lilly, LivaNova, Janssen, Medtronics, Merck, Occlutech, Owkin, Novartis, Novo Nordisk, Pharmacosmos, Pharmain, Pfizer, Prolaio, Regeneron, Renibus, Roche, Salamandra, Sanofi, SC Pharma, Secretome, Sequana, SQ Innovation, Tenex, Tricog, Ultromics, Vifor, and Zoll. VC: speaking fee from Novartis, Astra, Sanofi, Novo-Nordisk, Boehringer, Pfizer, Sun pharma, Glenmark, Mankind, Lupin, Intas, Dr.Reddy's. JLZ: speaker honoraria: Bayer, Daiichi, Pfizer. WTA: has received personal fees from AquaPass, Bioventrix, Cardiac Dimensions, Cordio Medical, CVRx, Innoventric, JNJ V-Wave, Relief Cardiovascular, Sensible Medical, Vectorious Medical Technologies, WhiteSwell, and Zoll Respicardia. |
| Contributed Indexing: | Keywords: Clinical practice guidelines; Implementation; Ischemic heart disease; Low-, middle-, and high-income countries; Obstacles; Survey |
| Entry Date(s): | Date Created: 20260701 Date Completed: 20260729 Latest Revision: 20260729 |
| Update Code: | 20260730 |
| DOI: | 10.1016/j.ijcard.2026.134637 |
| PMID: | 42386047 |
| Βάση Δεδομένων: | MEDLINE |
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