Baseline characteristics, management practices, and long-term outcomes of Middle Eastern patients in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-2)

Abstract

BACKGROUND AND OBJECTIVESLimited data are available on patients with acute coronary syndromes (ACS) and their long-term outcomes in the Arabian Gulf countries. We evaluated the clinical features, management, in-hospital, and long-term outcomes in such a population.DESIGN AND SETTINGA 9-month prospective, multicenter study conducted in 65 hospitals from 6 countries that also included 30 day and 1-year mortality follow-up.PATIENTS AND METHODSACS patients included those with ST-elevation myocardial infarction (STEMI) and non–ST-elevation acute coronary syndrome (NSTEACS), including non-STEMI and unstable angina. The registry collected the data prospectively.RESULTSBetween October 2008 and June 2009, 7930 patients were enrolled. The mean age [standard deviation (SD)], 56 (17) years; 78.8% men; 71.2% Gulf citizens; 50.1% with central obesity; and 45.6% with STEMI. A history of diabetes mellitus was present in 39.5%, hypertension in 47.2%, and hyperlipidemia in 32.7%, and 35.7% were current smokers. The median time from symptom onset to hospital arrival for STEMI patients was 178 minutes (interquartile range, 210 minutes); 22.3% had primary percutaneous coronary intervention (PCI) and 65.7% thrombolytic therapy, with 34% receiving therapy within 30 minutes of arrival. Evidence-based medication rates upon hospital discharge were 68% to 95%. The in-hospital PCI was done in 21% and the coronary artery bypass graft surgery in 2.9%. The in-hospital mortality was 4.6%, at 30 days the mortality was 7.2%, and at 1 year after hospital discharge the mortality was 9.4%; 1-year mortality was higher in STEMI (11.5%) than in NSTEACS patients (7.7%; P<.001).CONCLUSIONSCompared to developed countries, ACS patients in Arabian Gulf countries present at a relatively young age and have higher rates of metabolic syndrome features. STEMI patients present late, and their acute management is poor. In-hospital evidence-based medication rates are high, but coronary revascularization procedures are low. Long-term mortality rates increased severalfold compared with in-hospital mortality.

Twelve Months Outcomes in Patients With Acute Coronary Syndrome, by the National Registry Record-3

“…В одном из них смерт-ность через 1 год после выписки составила 9,4%, при-чем была значимо выше при ИМпST по сравнению с ОКСбпST (11,5% vs 7,7%) [5]. В другом [6] частота 12-месячной смертности после выписки составила 4,3% (и значимо не различалась между пациентами с ИМпST и ОКСбпST: 5,2% vs 3,9%; р=0,2).…”

“…These were coronary arteriography in-patient (odds ratio (OR) 0,11; 95% confidence interval (95% CI) 0,02-0,56; р=0,008), age ≥75 y. o. (OR 5,48; 95% CI 1,30; р=0,008), ST elevation on baseline ECG ≥1 mm (OR 3,43; 95% CI 1,(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)48; р=0,046). Conclusion.…”

β‐Blocker Therapy Prior to Admission for Acute Coronary Syndrome in Patients Without Heart Failure or Left Ventricular Dysfunction Improves In‐Hospital and 12‐Month Outcome: Results From the GULF‐RACE 2 (Gulf Registry of Acute Coronary Events‐2)

“…Details of patients' recruitment, study design, and methods have been previously published 7, 8. Briefly, we collected data, as per the case report form, of consecutive patients hospitalized for ACS in the 65 participating hospitals across the participating countries.…”

The importance of the First Jordanian Percutaneous Coronary Intervention Registry

“…Notwithstanding, the overall mortality rates were low and attributable in part to the younger age group and the high use of evidence-based medical therapy. [34] These findings have significant implications for improving care and outcome of ACS patients from Gulf countries.…”