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Impact of access to hospitals with catheterization facilities in the second Gulf Registry of Acute Coronary Events (Gulf RACE-2).
Coron Artery Dis. 2013 Aug; 24(5):412-8.CA

Abstract

OBJECTIVES

It is currently unclear whether acute coronary syndrome patients who access hospitals with catheterization facilities, with or without an on-site percutaneous coronary intervention (PCI), have better outcomes in real-life clinical practice.

METHODS AND RESULTS

This 9-month prospective study was carried out in six Arabian Gulf countries. Patients in hospitals with catheterization facilities [20/65 hospitals; 3615/6847 (52.8%) patients] were more likely to show evidence of cardiovascular risk factors (P<0.001) and more likely to undergo revascularization procedures that were mostly performed (≥80%) in low-risk and intermediate-risk patients. Patients in these centres experienced significantly higher rates of medical therapies and shorter door-to-needle times [median (IQR): 33 (40) vs. 43.5 (43) min, P<0.001]; 14.1% had primary PCI. They also had less in-hospital recurrent ischaemia, recurrent myocardial infarction, congestive heart failure and stroke, but more cardiogenic shock and major bleeding, and they had similar adjusted mortality rates in-hospital [odds ratio (OR): 1.06, 95% confidence interval (CI): 0.88-1.27] and at 30-day (OR: 1.11, 95% CI: 0.91-1.36) and 1-year (OR: 1.06, 95% CI: 0.89-1.27) follow-ups.

CONCLUSION

Access to hospitals with catheterization facilities, with or without on-site PCI, was associated with a reduction in recurrent myocardial infarction and recurrent ischaemia, but not mortality. Further efforts are required to target revascularization procedures for higher risk patients as well as to widely implement primary PCI programmes.

Authors+Show Affiliations

King Fahad Cardiac Center, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. khalidalhabib13@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23652362

Citation

Alhabib, Khalid F., et al. "Impact of Access to Hospitals With Catheterization Facilities in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-2)." Coronary Artery Disease, vol. 24, no. 5, 2013, pp. 412-8.
Alhabib KF, Jolly SS, Yusuf S, et al. Impact of access to hospitals with catheterization facilities in the second Gulf Registry of Acute Coronary Events (Gulf RACE-2). Coron Artery Dis. 2013;24(5):412-8.
Alhabib, K. F., Jolly, S. S., Yusuf, S., Alsheikh-Ali, A. A., Al Suwaidi, J., Hersi, A., Sulaiman, K., Al Saif, S., Almahmeed, W., Asaad, N., Amin, H., Al-Motarreb, A., Alfaleh, H., Alnemer, K., & Thalib, L. (2013). Impact of access to hospitals with catheterization facilities in the second Gulf Registry of Acute Coronary Events (Gulf RACE-2). Coronary Artery Disease, 24(5), 412-8. https://doi.org/10.1097/MCA.0b013e328361a910
Alhabib KF, et al. Impact of Access to Hospitals With Catheterization Facilities in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-2). Coron Artery Dis. 2013;24(5):412-8. PubMed PMID: 23652362.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of access to hospitals with catheterization facilities in the second Gulf Registry of Acute Coronary Events (Gulf RACE-2). AU - Alhabib,Khalid F, AU - Jolly,Sanjit S, AU - Yusuf,Salim, AU - Alsheikh-Ali,Alawi A, AU - Al Suwaidi,Jassim, AU - Hersi,Ahmad, AU - Sulaiman,Kadhim, AU - Al Saif,Shukri, AU - Almahmeed,Wael, AU - Asaad,Nidal, AU - Amin,Haitham, AU - Al-Motarreb,Ahmed, AU - Alfaleh,Hussam, AU - Alnemer,Khalid, AU - Thalib,Lukman, PY - 2013/5/9/entrez PY - 2013/5/9/pubmed PY - 2014/2/8/medline SP - 412 EP - 8 JF - Coronary artery disease JO - Coron. Artery Dis. VL - 24 IS - 5 N2 - OBJECTIVES: It is currently unclear whether acute coronary syndrome patients who access hospitals with catheterization facilities, with or without an on-site percutaneous coronary intervention (PCI), have better outcomes in real-life clinical practice. METHODS AND RESULTS: This 9-month prospective study was carried out in six Arabian Gulf countries. Patients in hospitals with catheterization facilities [20/65 hospitals; 3615/6847 (52.8%) patients] were more likely to show evidence of cardiovascular risk factors (P<0.001) and more likely to undergo revascularization procedures that were mostly performed (≥80%) in low-risk and intermediate-risk patients. Patients in these centres experienced significantly higher rates of medical therapies and shorter door-to-needle times [median (IQR): 33 (40) vs. 43.5 (43) min, P<0.001]; 14.1% had primary PCI. They also had less in-hospital recurrent ischaemia, recurrent myocardial infarction, congestive heart failure and stroke, but more cardiogenic shock and major bleeding, and they had similar adjusted mortality rates in-hospital [odds ratio (OR): 1.06, 95% confidence interval (CI): 0.88-1.27] and at 30-day (OR: 1.11, 95% CI: 0.91-1.36) and 1-year (OR: 1.06, 95% CI: 0.89-1.27) follow-ups. CONCLUSION: Access to hospitals with catheterization facilities, with or without on-site PCI, was associated with a reduction in recurrent myocardial infarction and recurrent ischaemia, but not mortality. Further efforts are required to target revascularization procedures for higher risk patients as well as to widely implement primary PCI programmes. SN - 1473-5830 UR - https://www.unboundmedicine.com/medline/citation/23652362/Impact_of_access_to_hospitals_with_catheterization_facilities_in_the_second_Gulf_Registry_of_Acute_Coronary_Events__Gulf_RACE_2__ L2 - http://dx.doi.org/10.1097/MCA.0b013e328361a910 DB - PRIME DP - Unbound Medicine ER -