Sub-Saharan Africa's Contribution to Clinical Trials in International Acute Coronary Syndromes and Heart Failure Guidelines
Authors' conclusion
There is a marked underrepresentation of SSA countries in ACS and HF pharmacotherapy RCTs. South Africa is the sole contributor from the region, which may affect applicability and generalizability of global guidelines to populations in SSA.
Study context
- Population
- Pharmacotherapeutic randomized controlled trials (RCTs) contributing to the 2021 European Society of Cardiology (ESC) heart failure (HF) and 2023 ESC acute coronary syndrome (ACS) guidelinesHF RCTs n = 119
- Outcome
- Proportion of RCTs including countries of each World Bank income group, focusing on SSA involvement, with temporal trends
Methodological detailssystematic analysis of RCTs underpinning ESC guidelines, data from ClinicalTrials.gov
- Systematic analysis of RCTs underpinning ESC guidelines
- Data from ClinicalTrials.gov
Main finding
As reported in the abstract
Representation of countries in guideline RCTs
- Conducted exclusively in high-income countries
- 75.9%
- Included middle-income countries
- 22.2%
- Included low-income countries
- 0
- HF RCTs with South Africa (sole sub-Saharan Africa (SSA) contributor)
- 14.2%
- ACS RCTs with South Africa (sole SSA contributor)
- 8.2%
Observational data: associations, not effects.
Further findings
Temporal trend, HF RCTs involving SSA
- 1990s
- 2.6%
- Post-2020
- 50%
- P for trend
- < 0.05
Temporal trend, ACS RCTs involving SSA
- Pre-1990
- 1.8%
- 2000 to 2009
- 23.4%
- P for trend
- 0.003
- Following decade
- 11.3%
Original publication
Sub-Saharan Africa's Contribution to Clinical Trials in International Acute Coronary Syndromes and Heart Failure Guidelines. JACC Adv. Published 26 December 2024. doi:10.
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