Medication use pattern and predictors of optimal therapy at discharge in 8176 patients with acute coronary syndrome from 6 Middle Eastern countries: Data from the gulf registry of acute coronary events

Ibrahim Al-Zakwani, Mohammad Zubaid, Prashanth Panduranga, Wafa Rashed, Kadhim Sulaiman, Wael Almahmeed, Ahmed Al-Motarreb, Jassim Al Suwaidi, Haitham Amin

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22 Citations (Scopus)


We evaluated the use of quadruple evidence-based medication (EBM) combination consisting of antiplatelet therapy, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and lipid-lowering agent concurrently at discharge among patients (n = 8154) with acute coronary syndrome (ACS) in 6 Middle Eastern countries. In all, 49% of the patients received the quadruple EBM combination concurrently at discharge. An adjusted model demonstrated that old age, diabetes mellitus, hyperlipidemia, hypertension, ST-segment elevation myocardial infarction, cardiac catheterization, as well as cardiologists as care providers and hospitals with cardiac catheterization facilities were all positively correlated with the use of the quadruple EBM combination. However, patients with cardiogenic shock, renal impairment, higher risk score, congestive heart failure, recurrent ischemia, and those admitted to academic hospitals were negatively correlated with the use of the quadruple EBM combination. Guideline adherence to the concurrent use of quadruple EBM combination in patients with ACS at discharge was suboptimal with wide disparity among the 6 countries.

Original languageEnglish
Pages (from-to)447-454
Number of pages8
Issue number6
Publication statusPublished - Aug 2011



  • acute coronary syndrome
  • antihypertensive agents
  • antiplatelet drugs
  • coronary heart disease
  • evidence-based medications
  • Middle East
  • statin
  • treatment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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