title: Management and outcomes of Middle Eastern patients admitted with acute coronary syndromes in the Gulf Registry of Acute Coronary Events (Gulf RACE).
abstract: OBJECTIVE
  To identify the characteristics, management and hospital outcomes of acute coronary syndrome (ACS) patients in the Gulf region of the Middle East.
  
  
  RESULTS
  Overall, 8176 consecutive patients with the final diagnosis of ACS were recruited in 6 months, from 64 hospitals in 6 countries. The mean age of patients was 56 years. At presentation, 40% of patients had diabetes and 38% were current smokers. Of 2268 patients eligible for reperfusion, 183 (8%) underwent primary percutaneous coronary intervention, 1856 (82%) received thrombolytic therapy and 219 patients (10%) did not receive any reperfusion. The median door-to-needle time was 45 minutes. The majority of patients received aspirin (96%), beta-blockers (77%), angiotensin-converting enzyme inhibitors (77%) and statins (83%) at discharge. Less than I in 5 patients received coronary angiography (19%). Low-risk patients were more likely to undergo coronary angiography than high-risk patients (odds ratio 1.35, 95% confidence interval 1.15 to 1.58, P < 0.001). Patients with recurrent ischaemia were 4 times more likely to undergo coronary angiography than those without; and patients who lived in UAE and Bahrain were about 3-4 times more likely to undergo this procedure than those who lived in other participating countries (P < 0.001 for both).The overall hospital mortality was 3.6%.
  
  
  CONCLUSIONS
  Patients with ACS in the Arab Middle East are younger than in developed countries and have higher rates of diabetes and smoking. There is good adherence to evidence-based medications; however, improvement in door-to-needle time and utilisation of interventional procedures is needed.
authors.affiliation: Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait. Zubaid@hsc.edu.kw
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zubaid
authors.forename: Wafa A
authors.initials: WA
authors.lastname: Rashed
authors.forename: Wael
authors.initials: W
authors.lastname: Almahmeed
authors.forename: Jawad
authors.initials: J
authors.lastname: Al-Lawati
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Motarreb
authors.forename: Haitham
authors.initials: H
authors.lastname: Amin
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
authors.forename: Khalid
authors.initials: K
authors.lastname: Alhabib
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology