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

Ibrahim Al-Zakwani, Kadhim Sulaiman, Mohammed Al Za'abi, Prashanth Panduranga, Khalid Al-Habib, Nidal Asaad, Ahmed Al Motarreb, Ahmad Hersi, Husam Al Faleh, Shukri Al Saif, Wael Almahmeed, Haitham Amin, Alawi Alsheikh-Ali, Jawad Al Lawati, Jassim Al Suwaidi

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)418-425
Number of pages8
JournalInternational Journal of Clinical Pharmacology and Therapeutics
Volume50
Issue number6
DOIs
Publication statusPublished - Jun 2012

Fingerprint

Acute Coronary Syndrome
clopidogrel
Registries
Mortality
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Middle East
Aspirin
Logistic Models
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Blood Platelets
Demography
Guidelines
Therapeutics

Keywords

  • Acute coronary syndrome
  • Evidence-based medicine
  • Middle East study
  • Mortality

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

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. / Al-Zakwani, Ibrahim; Sulaiman, Kadhim; Al Za'abi, Mohammed; Panduranga, Prashanth; Al-Habib, Khalid; Asaad, Nidal; Al Motarreb, Ahmed; Hersi, Ahmad; Al Faleh, Husam; Al Saif, Shukri; Almahmeed, Wael; Amin, Haitham; Alsheikh-Ali, Alawi; Al Lawati, Jawad; Al Suwaidi, Jassim.

In: International Journal of Clinical Pharmacology and Therapeutics, Vol. 50, No. 6, 06.2012, p. 418-425.

Research output: Contribution to journalArticle

Al-Zakwani, I, Sulaiman, K, Al Za'abi, M, Panduranga, P, Al-Habib, K, Asaad, N, Al Motarreb, A, Hersi, A, Al Faleh, H, Al Saif, S, Almahmeed, W, Amin, H, Alsheikh-Ali, A, Al Lawati, J & Al Suwaidi, J 2012, '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', International Journal of Clinical Pharmacology and Therapeutics, vol. 50, no. 6, pp. 418-425. https://doi.org/10.5414/CP201667
Al-Zakwani, Ibrahim ; Sulaiman, Kadhim ; Al Za'abi, Mohammed ; Panduranga, Prashanth ; Al-Habib, Khalid ; Asaad, Nidal ; Al Motarreb, Ahmed ; Hersi, Ahmad ; Al Faleh, Husam ; Al Saif, Shukri ; Almahmeed, Wael ; Amin, Haitham ; Alsheikh-Ali, Alawi ; Al Lawati, Jawad ; Al Suwaidi, Jassim. / 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. In: International Journal of Clinical Pharmacology and Therapeutics. 2012 ; Vol. 50, No. 6. pp. 418-425.
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abstract = "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.",
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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

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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.

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KW - Evidence-based medicine

KW - Middle East study

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