title: Impact of evidence-based cardiac medication on short- and long-term mortality in 7,567 acute coronary syndrome patients in the Gulf RACE-II registry.
abstract: OBJECTIVE
  To evaluate the impact of evidence-based cardiac medications (EBMs) on 1-month and 1-year mortality among discharged acute coronary syndrome (ACS) patients in the Middle East.
  
  
  METHODS
  Data were analyzed from 7,567 consecutive ACS patients admitted to 66 hospitals in 6 Middle Eastern countries enrolled in the Gulf RACE II in October 2008 to June 2009. Individual EBMs or concurrent use of the EBM combination consists of an anti-platelet therapy, angiotensin-converting enzyme inhibitor (ACEI) (or angiotensin II receptor blocker (ARB)), β-blocker, and a statin at discharge, were evaluated. Analyses were performed using univariate and multivariate statistical techniques.
  
  
  RESULTS
  The mean age of the cohort was 56 +/- 12 years with 79% being males. 65% of the patients received the concurrent EBM combination at discharge. Aspirin, clopidogrel, statins, b-blockers and ACEIs/ARBs use was 96%, 71%, 95%, 82% and 81%, respectively. 70% of the patients were prescribed both aspirin and clopidogrel concurrently at discharge. Adjusting for demographic, clinical, revascularization, and country characteristics, the multivariable logistic regression models demonstrated no differences in mortality at both 1-month (3.0 vs. 3.6%; p = 0.828) and 1-year (3.5 vs. 3.5%; p = 0.976) between the concurrent EBM combination users and non-users.
  
  
  CONCLUSIONS
  The majority of the ACS patients in the Middle East were prescribed the guideline recommended EBM combination at discharge. However, potential still remains for further optimization of management. Further studies are required to examine the long term effect of concurrent use of the EBM combination on mortality in the region.
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Zakwani
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al Za'abi
authors.forename: Prashanth
authors.initials: P
authors.lastname: Panduranga
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Habib
authors.forename: Nidal
authors.initials: N
authors.lastname: Asaad
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al Motarreb
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hersi
authors.forename: Husam
authors.initials: H
authors.lastname: Al Faleh
authors.forename: Shukri
authors.initials: S
authors.lastname: Al Saif
authors.forename: Wael
authors.initials: W
authors.lastname: Almahmeed
authors.forename: Haitham
authors.initials: H
authors.lastname: Amin
authors.forename: Alawi
authors.initials: A
authors.lastname: Alsheikh-Ali
authors.forename: Jawad
authors.initials: J
authors.lastname: Al Lawati
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000401:mortality*; D000328:Adult; D000368:Aged; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries