During the past 10 years, the health of people in Eastern Europe and the former Soviet Union has undergone changes very different from the health patterns seen in their Western counterparts. Mortality from cardiovascular disease has been decreasing continuously in the United States and many Western European countries, but it has increased or remained unchanged in many of the states of Eastern Europe. Analysis of this phenomenon has been hindered by insufficient information. Much has been hypothesised about the ethnicity- and poverty-associated disparities in mortality when comparing Eastern with Western European countries. Yet, identifying underlying causes for these worrisome geographic health patterns continues to challenge health care providers and researchers.

The International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-CT) is both a retrospective (over a one year period) and prospective (over a three year period) registry which was designed in order to obtain data of patients with acute coronary syndromes in countries with economy in transition, and herewith control and optimize internationally guideline recommended therapies in these countries. There are a total of 112 Collaborating Centers in 18 transitional countries (Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Hungary, Kosovo, Lavtia, Lithuania, Macedonia, Moldova, Poland, Romania, Russian Federation, Serbia, Slovakia, Slovenia, Ukraine) and a total of 30 centers in 2 industrialized countries (Italy, United Kingdom) that serve as control. The Registry is designed with 4 aims, (1) documentation of the characteristics of all patients presenting to the enrolled centers with STEMI or NSTEMI (2) documentation of in-hospital outcome, and outcome rates at 6 month and 1 year, (3) documentation of interventional cardiac procedures and related complications (4) documentation of therapeutic regimens and investigation conformity of treatment with already established guidelines. The registry encourages optimal individualization of evidence based therapies, and the international patient body ensures good representation of multiple practice patterns.

ISACS-CT is a large international investigative effort that will evaluate the role of evidence based therapies and interventional cardiac procedures over a three year period. It may help to make an additional improvement in clinical outcomes of countries with economy in transition.