title: Baseline characteristics, management practices, and in-hospital outcomes of patients with acute coronary syndromes: Results of the Saudi project for assessment of coronary events (SPACE) registry.
abstract: OBJECTIVE
  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%.
  
  
  CONCLUSIONS
  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.
authors: King Fahad Cardiac Center, King Khalid University Hospital, College of Medicine, King Saud University, Saudi Arabia.
authors: Khalid F
authors: KF
authors: Alhabib
authors: Ahmad
authors: A
authors: Hersi
authors: Hussam
authors: H
authors: Alfaleh
authors: Khalid
authors: K
authors: Alnemer
authors: Shukri
authors: S
authors: Alsaif
authors: Amir
authors: A
authors: Taraben
authors: Tarek
authors: T
authors: Kashour
authors: Anas
authors: A
authors: Bakheet
authors: Ayed Al
authors: AA
authors: Qarni
authors: Tariq
authors: T
authors: Soomro
authors: Asif
authors: A
authors: Malik
authors: Waqar H
authors: WH
authors: Ahmed
authors: Ahmed M
authors: AM
authors: Abuosa
authors: Modaser A
authors: MA
authors: Butt
authors: Mushabab A
authors: MA
authors: Almurayeh
authors: Abdulaziz Al
authors: AA
authors: Zaidi
authors: Gamal A
authors: GA
authors: Hussein
authors: Mohammed A
authors: MA
authors: Balghith
authors: Tareg
authors: T
authors: Abu-Ghazala
keywords: Acute coronary syndromes; Acute myocardial infarction; Middle East; Registry; Saudi Arabia; Unstable angina
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