title: Medication use pattern and predictors of optimal therapy at discharge in 8176 patients with acute coronary syndrome from 6 Middle Eastern countries: data from the gulf registry of acute coronary events.
abstract: We evaluated the use of quadruple evidence-based medication (EBM) combination consisting of antiplatelet therapy, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and lipid-lowering agent concurrently at discharge among patients (n = 8154) with acute coronary syndrome (ACS) in 6 Middle Eastern countries. In all, 49% of the patients received the quadruple EBM combination concurrently at discharge. An adjusted model demonstrated that old age, diabetes mellitus, hyperlipidemia, hypertension, ST-segment elevation myocardial infarction, cardiac catheterization, as well as cardiologists as care providers and hospitals with cardiac catheterization facilities were all positively correlated with the use of the quadruple EBM combination. However, patients with cardiogenic shock, renal impairment, higher risk score, congestive heart failure, recurrent ischemia, and those admitted to academic hospitals were negatively correlated with the use of the quadruple EBM combination. Guideline adherence to the concurrent use of quadruple EBM combination in patients with ACS at discharge was suboptimal with wide disparity among the 6 countries.
authors.affiliation: Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Gulf Health Research, Muscat, Oman. ial_zakwani@yahoo.com
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Zakwani
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zubaid
authors.forename: Prashanth
authors.initials: P
authors.lastname: Panduranga
authors.forename: Wafa
authors.initials: W
authors.lastname: Rashed
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.forename: Wael
authors.initials: W
authors.lastname: Almahmeed
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Motarreb
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
authors.forename: Haitham
authors.initials: H
authors.lastname: Amin
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East; D010351:Patient Discharge; D012042:Registries