We have shown in our previous registries in Saudi Arabia and the Arabian Gulf countries (SPACE and Gulf RACE-2) that patients presented with acute coronary syndromes at relatively young age because of the high prevalence of CAD risk factors. In addition, emergency medical services, acute care in the emergency department, and primary PCI were suboptimal compared to the international standards. However, the following factors should be considered:

1. Representation: many of the hospitals enrolled in these registries were tertiary care hospitals lead by enthusiastic cardiologists. There is under-representation of some health care sectors such as Ministry of Health (MOH) and private hospitals, particularly those at the peripheries of the country who are usually in-need more than others for improvement of care.

2. Temporal pattern: the above registries lack the temporal changes over the years in terms of the clinical presentations and the administered therapies in our health care system. This is important both individually at the hospital level and globally for the health care policies and planning on the long-term.

Countries with successful nation-wide databases (such as France, see attached FAST-AMI registry) have the ability to make solid health care planning and proper use of resources. We at the Saudi Heart Association strongly believe that we could replicate the same great experience mentioned above in Saudi Arabia through collaboration with all health care sectors in the country. This is a proposal to establish the Saudi acuTe myocArdial infaRction regiStry (STARS).

Vision: Improve hospital care provided for AMI patients.

Mission: establishment of a representative nation-wide AMI registry that monitors the burden of CAD risk factors, management, and outcomes of this patient population over the years in Saudi Arabia.

Under the auspices of