TY - JOUR
T1 - Impact of evidence-based cardiac medication on short- and long-term mortality in 7,567 acute coronary syndrome patients in the Gulf RACE-II registry
AU - Al-Zakwani, Ibrahim
AU - Sulaiman, Kadhim
AU - Al Za'abi, Mohammed
AU - Panduranga, Prashanth
AU - Al-Habib, Khalid
AU - Asaad, Nidal
AU - Al Motarreb, Ahmed
AU - Hersi, Ahmad
AU - Al Faleh, Husam
AU - Al Saif, Shukri
AU - Almahmeed, Wael
AU - Amin, Haitham
AU - Alsheikh-Ali, Alawi
AU - Al Lawati, Jawad
AU - Al Suwaidi, Jassim
PY - 2012/6
Y1 - 2012/6
N2 - Objective: To evaluate the impact of evidence-based cardiac medications (EBMs) on 1-month and 1-year mortality among discharged acute coronary syndrome (ACS) patients in the Middle East. Methods: Data were analyzed from 7,567 consecutive ACS patients admitted to 66 hospitals in 6 Middle Eastern countries enrolled in the Gulf RACE II in October 2008 to June 2009. Individual EBMs or concurrent use of the EBM combination consists of an anti-platelet therapy, angiotensin-converting enzyme inhibitor (ACEI) (or angiotensin II receptor blocker (ARB)), β-blocker, and a statin at discharge, were evaluated. Analyses were performed using univariate and multivariate statistical techniques. Results: The mean age of the cohort was 56 ± 12 years with 79% being males. 65% of the patients received the concurrent EBM combination at discharge. Aspirin, clopidogrel, statins, β-blockers and ACEIs/ARBs use was 96%, 71%, 95%, 82% and 81%, respectively. 70% of the patients were prescribed both aspirin and clopidogrel concurrently at discharge. Adjusting for demographic, clinical, revascularization, and country characteristics, the multivariable logistic regression models demonstrated no differences in mortality at both 1-month (3.0 vs. 3.6%; p = 0.828) and 1-year (3.5 vs. 3.5%; p = 0.976) between the concurrent EBM combination users and non-users. Conclusion: The majority of the ACS patients in the Middle East were prescribed the guideline recommended EBM combination at discharge. However, potential still remains for further optimization of management. Further studies are required to examine the long term effect of concurrent use of the EBM combination on mortality in the region.
AB - Objective: To evaluate the impact of evidence-based cardiac medications (EBMs) on 1-month and 1-year mortality among discharged acute coronary syndrome (ACS) patients in the Middle East. Methods: Data were analyzed from 7,567 consecutive ACS patients admitted to 66 hospitals in 6 Middle Eastern countries enrolled in the Gulf RACE II in October 2008 to June 2009. Individual EBMs or concurrent use of the EBM combination consists of an anti-platelet therapy, angiotensin-converting enzyme inhibitor (ACEI) (or angiotensin II receptor blocker (ARB)), β-blocker, and a statin at discharge, were evaluated. Analyses were performed using univariate and multivariate statistical techniques. Results: The mean age of the cohort was 56 ± 12 years with 79% being males. 65% of the patients received the concurrent EBM combination at discharge. Aspirin, clopidogrel, statins, β-blockers and ACEIs/ARBs use was 96%, 71%, 95%, 82% and 81%, respectively. 70% of the patients were prescribed both aspirin and clopidogrel concurrently at discharge. Adjusting for demographic, clinical, revascularization, and country characteristics, the multivariable logistic regression models demonstrated no differences in mortality at both 1-month (3.0 vs. 3.6%; p = 0.828) and 1-year (3.5 vs. 3.5%; p = 0.976) between the concurrent EBM combination users and non-users. Conclusion: The majority of the ACS patients in the Middle East were prescribed the guideline recommended EBM combination at discharge. However, potential still remains for further optimization of management. Further studies are required to examine the long term effect of concurrent use of the EBM combination on mortality in the region.
KW - Acute coronary syndrome
KW - Evidence-based medicine
KW - Middle East study
KW - Mortality
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U2 - 10.5414/CP201667
DO - 10.5414/CP201667
M3 - Article
C2 - 22541748
AN - SCOPUS:84861801848
SN - 0946-1965
VL - 50
SP - 418
EP - 425
JO - International Journal of Clinical Pharmacology and Therapeutics
JF - International Journal of Clinical Pharmacology and Therapeutics
IS - 6
ER -