Abstract
Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and
mortality among individuals with type 2 diabetes (T2D), particularly in regions with
high diabetes prevalence, like the Middle East and Africa (MEA). However, contemporary
data on ASCVD burden and management in these regions remain limited. The recent PACT-MEA
study evaluated the prevalence of established ASCVD (eASCVD), cardiovascular risk
profiles, and treatment practices in patients with T2D across seven countries. Several
manuscripts and presentations on aspects of the study were published in several journals
and conferences. This commentary consolidates a concise resume of the study. The PACT-MEA
study is a multinational, cross-sectional, observational chart review and physician
survey conducted across 55 centers in Bahrain, Egypt, Jordan, Kuwait, Qatar, South
Africa, and the United Arab Emirates. Data were collected from 3,726 adults with T2D
and approximately 400 physicians. The weighted prevalence of eASCVD was 20.9%, with
substantial variation by age and country. Nearly all participants have high or very
high cardiovascular risk. Only 30 to 37% met individual treatment targets for HbA1c,
blood pressure, and low-density lipoprotein cholesterol. Utilization of cardioprotective
therapies was suboptimal. No participant achieved all guideline targets. The PACT-MEA
and DISCOVER-MEA studies shared some objectives but differed in scope, design, and
primary outcomes. The burden of ASCVD and associated risk among patients with T2D
in the MEA region is alarmingly high, but comprehensive risk factor control is insufficient.
The PACT-MEA study findings underscored an urgent need for targeted regional strategies
to improve cardiovascular outcomes.
Keywords
type 2 diabetes - atherosclerotic cardiovascular disease - cardiovascular risk - Middle
East - Africa - PACT-MEA - DISCOVER
