Kuwait Acute Coronary Syndromes Registry: Baseline Characteristics, Management Practices and In-Hospital Outcomes of Patients Hospitalized with Acute Coronary Syndromes in Kuwait

Objectives: To identify the characteristics of patients with acute coronary syndromes (ACS), their hospital management and in-hospital outcomes, through a prospective registry system in Kuwait. Subjects and Methods: A registry involving all 7 general hospitals in Kuwait was set up. Consecutive patients diagnosed as having ACS over a period of 6 months were enrolled. Results: Of 2,129 patients enrolled, 718 (34%) had ST segment elevation myocardial infarction (STEMI), 576 (27%) non-ST segment elevation myocardial infarction (NSTEMI) and 835 (39%) unstable angina (UA). Thrombolytic therapy was used in 556 (77%) patients with STEMI. The median time from diagnostic electrocardiogram to administration of thrombolytic therapy was 38 min. Almost all patients with ACS (2,050, 96%) received aspirin during hospitalization. Only a minority received clopidogrel, 18 (3%) STEMI, 36 (6%) NSTEMI and 96 (12%) UA patients. The use of glycoprotein IIb/IIIa antagonists was minimal (38 patients, 2%). β-Blockers were used in 1,473 (69%) patients, while 982 (46%) received angiotensin-converting enzyme inhibitors. Coronary angiography during hospitalization was performed in 119 (17%), 120 (21%) and 126 (15%) patients with STEMI, NSTEMI and UA, respectively. In-hospital mortality occurred in 31 (4%) myocardial infarction patients and 4 (0.5%) UA patients (p 0.0001). Conclusion: This registry has enabled us to determine the incidence and characteristics of ACS patients in Kuwait. It has also enabled us to identify some barriers that we need to overcome for the full implementation of published guidelines for the management of patients with ACS.