TY - JOUR
T1 - Medication use pattern and predictors of optimal therapy at discharge in 8176 patients with acute coronary syndrome from 6 Middle Eastern countries
T2 - Data from the gulf registry of acute coronary events
AU - Al-Zakwani, Ibrahim
AU - Zubaid, Mohammad
AU - Panduranga, Prashanth
AU - Rashed, Wafa
AU - Sulaiman, Kadhim
AU - Almahmeed, Wael
AU - Al-Motarreb, Ahmed
AU - Al Suwaidi, Jassim
AU - Amin, Haitham
PY - 2011/8
Y1 - 2011/8
N2 - 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.
AB - 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.
KW - Middle East
KW - acute coronary syndrome
KW - antihypertensive agents
KW - antiplatelet drugs
KW - coronary heart disease
KW - evidence-based medications
KW - statin
KW - treatment
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U2 - 10.1177/0003319710394163
DO - 10.1177/0003319710394163
M3 - Article
C2 - 21421625
AN - SCOPUS:79960958649
SN - 0003-3197
VL - 62
SP - 447
EP - 454
JO - Angiology
JF - Angiology
IS - 6
ER -