Author/Authors :
Alhabib, Khalid F. King Saud University - College of Medicine, King Khalid University Hospital, King Fahad Cardiac Center, Saudi Arabia , Hersi, Ahmad King Saud University - College of Medicine, King Khalid University Hospital, King Fahad Cardiac Center, Saudi Arabia , AlFaleh, Hussam King Saud University - College of Medicine, King Khalid University Hospital, King Fahad Cardiac Center, Saudi Arabia , ALNemer, Khalid Security Forces Hospital, Saudi Arabia , AlSaif, Shukri Saud Al Babtain Cardiac Center, Saudi Arabia , Taraben, Amir King Faisal Specialist Hospital and Research Center, Saudi Arabia , Kashour, Tarek University of Manitoba - Prince Salman Heart Center, King Fahd Medical City - Department of Medicine, Canada , Bakheet, Anas Prince Salman Hospital, Saudi Arabia , Al Qarni, Ayed King Khalid Hospital - Prince Sultan Center, Saudi Arabia , Soomro, Tariq Prince Sultan Cardiac Center, Saudi Arabia , Malik, Asif King Fahad General Hospital, Saudi Arabia , Ahmed, Waqar H. King Fahd Armed Forces Hospital, Saudi Arabia , Abuosa, Ahmed M. King Khalid National Guard Hospital, Saudi Arabia , Butt, Modaser A. King Khalid Civilian Hospital, Saudi Arabia , AlMurayeh, Mushabab A. Armed Forces Hospital Southern Region, Saudi Arabia , Al Zaidi, Abdulaziz Military Hospital - Prince Sultan Cardiac Center, Saudi Arabia , Hussein, Gamal A. North West Armed Forces Hospital, Saudi Arabia , Balghith, Mohammed A. King Abdulaziz Medical City - Cardiac Center, Saudi Arabia , Abu-Ghazala, Tareg International Medical Center, Saudi Arabia
Abstract :
Objectives: The 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. Methods: We 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). Results: 5055 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%. Conclusion: ACS 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.
