The Saudi Project for Assessment of Coronary Events (SPACE) registry: Design and results of a phase I pilot study |
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| Authors: | Khalid F AlHabib Ahmad Hersi Hussam AlFaleh Mohammad Kurdi Mohammad Arafah Mostafa Youssef Khalid AlNemer Anas Bakheet Ayed AlQarni Tariq Soomro Amir Taraben Asif Malik and Waqar H Ahmed |
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| Institution: | 1King Fahad Cardiac Centre, College of Medicine, King Saud University;;2King Fahd Medical City, Prince Salman Heart Center;;3Prince Salman Hospital, Riyadh;;4King Khalid Hospital, Prince Sultan Center, AlKharj;;5Prince Sultan Cardiac Center, AlQassim;;6King Faisal Specialist Hospital and Research Center, Jeddah;;7King Fahd General Hospital, Jeddah;;8King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia |
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| Abstract: | OBJECTIVE:The delay between the availability of clinical evidence and its application to the care of patients with acute coronary syndrome (ACS) in the Kingdom of Saudi Arabia remains undefined. The Saudi Project for Assessment of Coronary Events (SPACE) registry provides a comprehensive view of the current diagnostic and treatment strategies for patients with ACS; thus, the registry may be used to identify opportunities to improve the care of these patients.METHODS:Eight hospitals in different regions of Saudi Arabia were involved in the pilot phase of the registry, from December 2005 to July 2006. The study patients included individuals with ST segment elevation myocardial infarction (STEMI), non-STEMI and unstable angina.RESULTS:A total of 435 patients (77% men and 80% Saudis) with a mean age of 57.1 years were enrolled. Medical history included previously diagnosed ischemic heart disease (32%), percutaneous coronary intervention (12%), diabetes mellitus (53%), hypertension (48%), current smoking (39%), hyperlipidemia (31%) and family history of premature coronary artery disease (11%). The median door-to-needle time for fibrinolytic therapy received by patients with STEMIs was 90 min. Inhospital medications included acetylsalicylic acid (98%), clopidogrel (73%), angiotensin-converting enzyme inhibitors (74%), beta-blockers (73%), statins (88%), unfractionated heparin (80%), low-molecular weight heparin (22%) and glycoprotein IIb/IIIa inhibitors (9%). The inhospital mortality rate was 5%.CONCLUSION:The first nationwide registry of patients with ACS in the Kingdom of Saudi Arabia is presented. In contrast to registries from developed countries, our cohort is characterized by a younger age at presentation and a much higher prevalence of diabetes mellitus. Most patients with STEMIs did not receive fibrinolytic therapy within the time recommended in the American College of Cardiology/American Heart Association guidelines. The results of the present pilot study show potential targets for improvement in care. |
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| Keywords: | Acute coronary syndrome Fibrinolytic therapy Middle East Registry Saudi Arabia |
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