TY - JOUR
T1 - Primary coronary intervention versus thrombolytic therapy in myocardial infarction patients in the Middle East
AU - Al-Zakwani, Ibrahim
AU - Zubaid, Mohammad
AU - Al-Riyami, Adil
AU - Alanbaei, Muath
AU - Sulaiman, Kadhim
AU - Almahmeed, Wael
AU - Al-Motarreb, Ahmed
AU - Al Suwaidi, Jassim
N1 - Funding Information:
Funding We disclose the receipt of a grant for this Gulf RACE project from Gulf Heart Association with finances supported by Sa-nofi Aventis and Qatar Telecommunications Company.
PY - 2012/6
Y1 - 2012/6
N2 - Background Little is known about predictors and outcome differences of primary percutaneous coronary intervention (PPCI) and thrombolytic therapy (TT) in ST-segment elevation myocardial infarction (STEMI) patients in the Middle East. Objective To compare predictors as well as in-hospital outcomes of PPCI and TT in STEMI patients in six Middle Eastern countries. Setting Sixty-five hospitals (covering at least 85 % of the population) in Oman, United Arab Emirates, Qatar, Bahrain, Kuwait and Yemen. Methods This was a prospective, multinational, multicentre, observational survey of consecutive acute coronary syndrome patients who were admitted to 65 hospitals during May 8, 2006 to June 6, 2006 and from January 29, 2007 to June 29, 2007, as part of Gulf RACE (Registry of Acute Coronary Events). Analyses were performed using univariate and multivariate statistical techniques. Main outcome measures Predictors as well as inhospital outcomes of PPCI and TT in STEMI patients. Results Out of 2,155 STEMI patients admitted to hospitals within 12 h of symptoms onset, 92 % received reperfusion (8 % PPCI and 84 % TT). TT use included reteplase (43 %), tenecteplase (30 %), streptokinase (25 %), and alteplase (2 %). Median age of the study cohort was 50 (44-58) years with majority being males (90 %). There were no significant differences in median onset time to presentation between the TT and PPCI groups (130 vs. 120 min; P = 0.422). Median door-to-needle time and door-to-balloon time were 45 min (29-75) and 75 min (58-120), respectively. Predictors of PPCI included prior PCI, hospitals with catheterization laboratory facilities as well as those involved with academia. Multivariate logistic regression model demonstrated that patients that had PPCI were less likely to have recurrent ischemic attacks than those that had TT (odds ratio, 0.18; 95 % CI, 0.06-0.56; P = 0.003). Conclusions The main reperfusion strategy for STEMI patients in the Arab Middle East region is throm-bolytic therapy. Predictors of primary percutaneous coronary intervention included prior percutaneous coronary intervention, hospitals with catheterization laboratory facilities as well as those involved with academia. Primary percutaneous coronary intervention resulted in significant reductions in recurrent ischemic events when compared to thrombolytic therapy.
AB - Background Little is known about predictors and outcome differences of primary percutaneous coronary intervention (PPCI) and thrombolytic therapy (TT) in ST-segment elevation myocardial infarction (STEMI) patients in the Middle East. Objective To compare predictors as well as in-hospital outcomes of PPCI and TT in STEMI patients in six Middle Eastern countries. Setting Sixty-five hospitals (covering at least 85 % of the population) in Oman, United Arab Emirates, Qatar, Bahrain, Kuwait and Yemen. Methods This was a prospective, multinational, multicentre, observational survey of consecutive acute coronary syndrome patients who were admitted to 65 hospitals during May 8, 2006 to June 6, 2006 and from January 29, 2007 to June 29, 2007, as part of Gulf RACE (Registry of Acute Coronary Events). Analyses were performed using univariate and multivariate statistical techniques. Main outcome measures Predictors as well as inhospital outcomes of PPCI and TT in STEMI patients. Results Out of 2,155 STEMI patients admitted to hospitals within 12 h of symptoms onset, 92 % received reperfusion (8 % PPCI and 84 % TT). TT use included reteplase (43 %), tenecteplase (30 %), streptokinase (25 %), and alteplase (2 %). Median age of the study cohort was 50 (44-58) years with majority being males (90 %). There were no significant differences in median onset time to presentation between the TT and PPCI groups (130 vs. 120 min; P = 0.422). Median door-to-needle time and door-to-balloon time were 45 min (29-75) and 75 min (58-120), respectively. Predictors of PPCI included prior PCI, hospitals with catheterization laboratory facilities as well as those involved with academia. Multivariate logistic regression model demonstrated that patients that had PPCI were less likely to have recurrent ischemic attacks than those that had TT (odds ratio, 0.18; 95 % CI, 0.06-0.56; P = 0.003). Conclusions The main reperfusion strategy for STEMI patients in the Arab Middle East region is throm-bolytic therapy. Predictors of primary percutaneous coronary intervention included prior percutaneous coronary intervention, hospitals with catheterization laboratory facilities as well as those involved with academia. Primary percutaneous coronary intervention resulted in significant reductions in recurrent ischemic events when compared to thrombolytic therapy.
KW - Arab Countries
KW - Ischemic attack
KW - Myocardial infarction
KW - Primary angioplasty
KW - Thrombolysis
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U2 - 10.1007/s11096-012-9627-1
DO - 10.1007/s11096-012-9627-1
M3 - Article
C2 - 22477207
AN - SCOPUS:84862993645
SN - 2210-7703
VL - 34
SP - 445
EP - 451
JO - International Journal of Clinical Pharmacy
JF - International Journal of Clinical Pharmacy
IS - 3
ER -