BACKGROUND: Lack of timely reperfusion therapy in patients with ST-elevation myocardial infarction (STEMI) has been associated with worse outcomes. The aim of this study is to identify the frequency and predictors of delayed presentation and missed reperfusion in patients with STEMI in the Gulf Register of Acute Coronary Events (Gulf RACE) registry. Delayed Presentation and missed reperfusion is associated with increased in hospital mortality in STEMI patients. METHODS: Gulf RACE is a prospective, multinational study of all consecutive patients hospitalized with the final diagnosis of acute coronary syndrome in 65 centers in 6 Arab countries. In this analysis, we included 3197 patients with STEMI. The independent predictors of delayed presentation and missed reperfusion therapy were identified using multivariate logistic regression. RESULTS: In total, 929 patients presented > 12 hours after symptom onset. The independent predictors of late presentation are older age, atypical symptoms, no family history of coronary artery disease, and being in Yemen. Of the 2268 STEMI patients presenting early, a total of 205 patients (9.3%) did not receive reperfusion therapy despite no contraindications (shortfall). The independent predictors of not receiving appropriate reperfusion therapy are older age, prior stroke, being in Yemen, and atypical symptoms. Lack of reperfusion therapy due to shortfall or delayed presentation was associated with increased in-hospital mortality. CONCLUSIONS: Nearly one-third of patients with STEMI in the Arab Middle East present to the hospital > 12 hours after symptom onset, and nearly 1 in 10 eligible patients do not receive any reperfusion therapy. Community and physician awareness programs are needed to increase the utilization of appropriate lifesaving therapies.
BACKGROUND: Lack of timely reperfusion therapy in patients with ST-elevation myocardial infarction (STEMI) has been associated with worse outcomes. The aim of this study is to identify the frequency and predictors of delayed presentation and missed reperfusion in patients with STEMI in the Gulf Register of Acute Coronary Events (Gulf RACE) registry. Delayed Presentation and missed reperfusion is associated with increased in hospital mortality in STEMI patients. METHODS: Gulf RACE is a prospective, multinational study of all consecutive patients hospitalized with the final diagnosis of acute coronary syndrome in 65 centers in 6 Arab countries. In this analysis, we included 3197 patients with STEMI. The independent predictors of delayed presentation and missed reperfusion therapy were identified using multivariate logistic regression. RESULTS: In total, 929 patients presented > 12 hours after symptom onset. The independent predictors of late presentation are older age, atypical symptoms, no family history of coronary artery disease, and being in Yemen. Of the 2268 STEMI patients presenting early, a total of 205 patients (9.3%) did not receive reperfusion therapy despite no contraindications (shortfall). The independent predictors of not receiving appropriate reperfusion therapy are older age, prior stroke, being in Yemen, and atypical symptoms. Lack of reperfusion therapy due to shortfall or delayed presentation was associated with increased in-hospital mortality. CONCLUSIONS: Nearly one-third of patients with STEMI in the Arab Middle East present to the hospital > 12 hours after symptom onset, and nearly 1 in 10 eligible patients do not receive any reperfusion therapy. Community and physician awareness programs are needed to increase the utilization of appropriate lifesaving therapies.
Authors: Ibrahim Al-Zakwani; Mohammad Zubaid; Adil Al-Riyami; Muath Alanbaei; Kadhim Sulaiman; Wael Almahmeed; Ahmed Al-Motarreb; Jassim Al Suwaidi Journal: Int J Clin Pharm Date: 2012-04-03
Authors: Khalid F Alhabib; Ahmad Hersi; Hussam Alfaleh; Khalid Alnemer; Shukri Alsaif; Amir Taraben; Tarek Kashour; Anas Bakheet; Ayed Al Qarni; Tariq Soomro; Asif Malik; Waqar H Ahmed; Ahmed M Abuosa; Modaser A Butt; Mushabab A Almurayeh; Abdulaziz Al Zaidi; Gamal A Hussein; Mohammed A Balghith; Tareg Abu-Ghazala Journal: J Saudi Heart Assoc Date: 2011-06-01
Authors: Abdulla Shehab; Khalid Al-Habib; Ahmed Hersi; Husam Al-Faleh; Alawi Alsheikh-Ali; Wael Almahmeed; Kadhim J Suleiman; Ahmed Al-Motarreb; Jassim Al Suwaidy; Nidal Asaad; Shukri AlSaid; Muhammad Hashim; Haitham Amin Journal: Ann Saudi Med Date: 2014 Nov-Dec Impact factor: 1.526
Authors: Khalid Bin Thani; Fajer Al-Moosa; Eman Murad; Aisha Al-Moosa; Mohamed E Alalawi; Hind Al-Sindi Journal: Open Cardiovasc Med J Date: 2015-12-29