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Document Details :
Title: Management and outcomes of Middle Eastern patients admitted with acute coronary syndromes in the Gulf Registry of Acute Coronary Events (Gulf RACE)
Author(s): M. Zubaid , W.A. Rashed , W. Almahmeed , J. Al-Lawati , K. Sulaiman , A. Al-Motarreb , H. Amin , J.A. Suwaidi , K. Alhabib
Journal: Acta Cardiologica
Volume: 64 Issue: 4 Date: 2009
Objectives — To identify the characteristics, management and hospital outcomes of acute coronary syndrome (ACS) patients in the Gulf region of the Middle East.
Methods and results — Overall, 8176 consecutive patients with the final diagnosis of ACS were recruited in 6 months, from 64 hospitals in 6 countries. The mean age of patients was 56 years. At presentation, 40% of patients had diabetes and 38% were current smokers. Of 2268 patients eligible for reperfusion, 183 (8%) underwent primary percutaneous coronary intervention, 1856 (82%) received thrombolytic therapy and 219 patients (10%) did not receive any reperfusion. The median door-to-needle time was 45 minutes. The majority of patients received aspirin (96%), beta-blockers (77%), angiotensin-converting enzyme inhibitors (77%) and statins (83%) at discharge. Less than 1 in 5 patients received coronary angiography (19%). Low-risk patients were more likely to undergo coronary angiography than high-risk patients (odds ratio 1.35, 95% confidence interval 1.15 to 1.58, P < 0.001). Patients with recurrent ischaemia were 4 times more likely to undergo coronary angiography than those without; and patients who lived in UAE and Bahrain were about 3-4 times more likely to undergo this procedure than those who lived in other participating countries (P < 0.001 for both). The overall hospital mortality was 3.6%.
Conclusions — Patients with ACS in the Arab Middle East are younger than in developed countries and have higher rates of diabetes and smoking. There is good adherence to evidence-based medications; however, improvement in door-to-needle time and utilisation of interventional procedures is needed.