Baseline characteristics, management practices, and in-hospital outcomes of patients with acute coronary syndromes: Results of the Saudi project for assessment of coronary events (SPACE) registry |
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| 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 |
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| Affiliation: | aKing Fahad Cardiac Center, King Khalid University Hospital, College of Medicine, King Saud University, Saudi Arabia;bSecurity Forces Hospital, Riyadh, Saudi Arabia;cSaud Al Babtain Cardiac Center, Dammam, Saudi Arabia;dKing Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia;ePrince Salman Heart Center, King Fahd Medical City and Department of Medicine, University of Manitoba, Winnipeg, Canada;fPrince Salman Hospital, Riyadh, Saudi Arabia;gKing Khalid Hospital, Prince Sultan Center, Al Kharj, Saudi Arabia;hPrince Sultan Cardiac Center, AlQassim, Saudi Arabia;iKing Fahad General Hospital, Saudi Arabia;jKing Fahd Armed Forces Hospital, Saudi Arabia;kKing Khalid National Guard Hospital, Jeddah, Saudi Arabia;lKing Khalid Civilian Hospital, Tabuk, Saudi Arabia;mArmed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia;nPrince Sultan Cardiac Center, Military Hospital, Riyadh, Saudi Arabia;oNorth West Armed Forces Hospital, Tabuk, Saudi Arabia;pKing Abdulaziz Medical City, Cardiac Center, National Guard, Riyadh, Saudi Arabia;qInternational Medical Center, Jeddah, Saudi Arabia |
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| Abstract: | ![]()
ObjectivesThe Saudi Project for Assessment of Coronary Events (SPACE) registry is the first in Saudi Arabia to study the clinical features, management, and in-hospital outcomes of acute coronary syndrome (ACS) patients.MethodsWe conducted a prospective registry study in 17 hospitals in Saudi Arabia between December 2005 and December 2007. ACS patients included those with ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction and unstable angina; both were reported collectively as NSTEACS (non-ST elevation acute coronary syndrome).Results5055 patients were enrolled with mean age ± SD of 58 ± 12.9 years; 77.4% men, 82.4% Saudi nationals; 41.5% had STEMI, and 5.1% arrived at the hospital by ambulance. History of diabetes mellitus was present in 58.1%, hypertension in 55.3%, hyperlipidemia in 41.1%, and 32.8% were current smokers; all these were more common in NSTEACS patients, except for smoking (all P < 0.0001). In-hospital medications were: aspirin (97.7%), clopidogrel (83.7%), beta-blockers (81.6%), angiotensin converting enzyme inhibitors/angiotensin receptor blockers (75.1%), and statins (93.3%). Median time from symptom onset to hospital arrival for STEMI patients was 150 min (IQR: 223), 17.5% had primary percutaneous coronary intervention (PCI), 69.1% had thrombolytic therapy, and 14.8% received it at less than 30 min of hospital arrival. In-hospital outcomes included recurrent myocardial infarction (1.5%), recurrent ischemia (12.6%), cardiogenic shock (4.3%), stroke (0.9%), major bleeding (1.3%). In-hospital mortality was 3.0%.ConclusionACS patients in Saudi Arabia present at a younger age, have much higher prevalence of diabetes mellitus, less access to ambulance use, delayed treatment by thrombolytic therapy, and less primary PCI compared with patients in the developed countries. This is the first national ACS registry in our country and it demonstrated knowledge-care gaps that require further improvements. |
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| Keywords: | Acute coronary syndromes Acute myocardial infarction Unstable angina Registry Saudi Arabia Middle East |
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