The quality of care in acute coronary syndrome and its association with mortality in the united arab emirates: Data from the gulf race

A. Shehab, J. Yasin, B. Al-Dabbagh, M. J. Hashim, W. Almahmeed, N. Bustani, A. Agrawal, A. H. Yusufali, A. Wassef, A. Alnaeemi, Abdishakur Abdulle

Research output: Contribution to journalArticle

Abstract

Aim. Objective of the present study was to evaluate the quality of care and outcome in patients with acute coronary syndrome (ACS) according to international guidelines.

Methods. We used data from the Gulf Registry of Acute Coronary Events (Gulf RACE). A sub sample of 1693 patients from the United Arab Emirates (UAE) was analyzed.

Results. In all ACS patients, aspirin and statins were adequately prescribed on admission and at discharge, whereas, the treatment with an- giotensin-converting enzyme inhibitor (ACEI)/ angiotensin II receptor blocker (ARIIB), clopi- dogrel, and beta-blockers (BB), increased at discharge according to guideline-recommend- ed treatment. The use of clopidogrel and BB at discharge was significantly different in the three ACS classes. Patients who were receiving all five guideline-recommended drugs, were mainly males (P=0.0001) and more in the age groups of (< 55 and 55-74 years). Smokers were better treated than non-smokers, but patients with prior coronary artery disease (CAD) did not receive optimal treatment. Mortality was significantly (P=0.0001) less among the subjects who received adequate treatment (0.1%) than those who did not (4.3%). Multivariate regression analysis, showed that age [adjusted OR: 1.051; 95% CI: 1.015-1.089; P=0.0051 and the use of all five guideline-rec- ommend drugs [adjusted OR: 0.042; 95% CI: 0.005-0.319; P=0.002 (protective effect)! were independent predictors of death.

Conclusion. The quality of care for patients with ACS in the UAE seems to be modest and the use of guideline-recommended drugs is suboptimal. The need for improved care, particularly, among elder patients, and adherence to guideline-recommended treatment is highlighted.

Original languageEnglish (US)
Pages (from-to)377-382
Number of pages6
JournalGazzetta Medica Italiana Archivio per le Scienze Mediche
Volume173
Issue number7-8
StatePublished - Jan 1 2014

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United Arab Emirates
Quality of Health Care
Acute Coronary Syndrome
clopidogrel
Guidelines
Mortality
Pharmaceutical Preparations
Therapeutics
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Angiotensin Receptor Antagonists
Patient Compliance
Angiotensin-Converting Enzyme Inhibitors
Aspirin
Registries
Coronary Artery Disease
Multivariate Analysis
Age Groups
Regression Analysis

Keywords

  • Acute coronary syndrome
  • Coronary vessels
  • Quality of health care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The quality of care in acute coronary syndrome and its association with mortality in the united arab emirates : Data from the gulf race. / Shehab, A.; Yasin, J.; Al-Dabbagh, B.; Hashim, M. J.; Almahmeed, W.; Bustani, N.; Agrawal, A.; Yusufali, A. H.; Wassef, A.; Alnaeemi, A.; Abdulle, Abdishakur.

In: Gazzetta Medica Italiana Archivio per le Scienze Mediche, Vol. 173, No. 7-8, 01.01.2014, p. 377-382.

Research output: Contribution to journalArticle

Shehab, A, Yasin, J, Al-Dabbagh, B, Hashim, MJ, Almahmeed, W, Bustani, N, Agrawal, A, Yusufali, AH, Wassef, A, Alnaeemi, A & Abdulle, A 2014, 'The quality of care in acute coronary syndrome and its association with mortality in the united arab emirates: Data from the gulf race', Gazzetta Medica Italiana Archivio per le Scienze Mediche, vol. 173, no. 7-8, pp. 377-382.
Shehab, A. ; Yasin, J. ; Al-Dabbagh, B. ; Hashim, M. J. ; Almahmeed, W. ; Bustani, N. ; Agrawal, A. ; Yusufali, A. H. ; Wassef, A. ; Alnaeemi, A. ; Abdulle, Abdishakur. / The quality of care in acute coronary syndrome and its association with mortality in the united arab emirates : Data from the gulf race. In: Gazzetta Medica Italiana Archivio per le Scienze Mediche. 2014 ; Vol. 173, No. 7-8. pp. 377-382.
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abstract = "Aim. Objective of the present study was to evaluate the quality of care and outcome in patients with acute coronary syndrome (ACS) according to international guidelines.Methods. We used data from the Gulf Registry of Acute Coronary Events (Gulf RACE). A sub sample of 1693 patients from the United Arab Emirates (UAE) was analyzed.Results. In all ACS patients, aspirin and statins were adequately prescribed on admission and at discharge, whereas, the treatment with an- giotensin-converting enzyme inhibitor (ACEI)/ angiotensin II receptor blocker (ARIIB), clopi- dogrel, and beta-blockers (BB), increased at discharge according to guideline-recommend- ed treatment. The use of clopidogrel and BB at discharge was significantly different in the three ACS classes. Patients who were receiving all five guideline-recommended drugs, were mainly males (P=0.0001) and more in the age groups of (< 55 and 55-74 years). Smokers were better treated than non-smokers, but patients with prior coronary artery disease (CAD) did not receive optimal treatment. Mortality was significantly (P=0.0001) less among the subjects who received adequate treatment (0.1{\%}) than those who did not (4.3{\%}). Multivariate regression analysis, showed that age [adjusted OR: 1.051; 95{\%} CI: 1.015-1.089; P=0.0051 and the use of all five guideline-rec- ommend drugs [adjusted OR: 0.042; 95{\%} CI: 0.005-0.319; P=0.002 (protective effect)! were independent predictors of death.Conclusion. The quality of care for patients with ACS in the UAE seems to be modest and the use of guideline-recommended drugs is suboptimal. The need for improved care, particularly, among elder patients, and adherence to guideline-recommended treatment is highlighted.",
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T1 - The quality of care in acute coronary syndrome and its association with mortality in the united arab emirates

T2 - Data from the gulf race

AU - Shehab, A.

AU - Yasin, J.

AU - Al-Dabbagh, B.

AU - Hashim, M. J.

AU - Almahmeed, W.

AU - Bustani, N.

AU - Agrawal, A.

AU - Yusufali, A. H.

AU - Wassef, A.

AU - Alnaeemi, A.

AU - Abdulle, Abdishakur

PY - 2014/1/1

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N2 - Aim. Objective of the present study was to evaluate the quality of care and outcome in patients with acute coronary syndrome (ACS) according to international guidelines.Methods. We used data from the Gulf Registry of Acute Coronary Events (Gulf RACE). A sub sample of 1693 patients from the United Arab Emirates (UAE) was analyzed.Results. In all ACS patients, aspirin and statins were adequately prescribed on admission and at discharge, whereas, the treatment with an- giotensin-converting enzyme inhibitor (ACEI)/ angiotensin II receptor blocker (ARIIB), clopi- dogrel, and beta-blockers (BB), increased at discharge according to guideline-recommend- ed treatment. The use of clopidogrel and BB at discharge was significantly different in the three ACS classes. Patients who were receiving all five guideline-recommended drugs, were mainly males (P=0.0001) and more in the age groups of (< 55 and 55-74 years). Smokers were better treated than non-smokers, but patients with prior coronary artery disease (CAD) did not receive optimal treatment. Mortality was significantly (P=0.0001) less among the subjects who received adequate treatment (0.1%) than those who did not (4.3%). Multivariate regression analysis, showed that age [adjusted OR: 1.051; 95% CI: 1.015-1.089; P=0.0051 and the use of all five guideline-rec- ommend drugs [adjusted OR: 0.042; 95% CI: 0.005-0.319; P=0.002 (protective effect)! were independent predictors of death.Conclusion. The quality of care for patients with ACS in the UAE seems to be modest and the use of guideline-recommended drugs is suboptimal. The need for improved care, particularly, among elder patients, and adherence to guideline-recommended treatment is highlighted.

AB - Aim. Objective of the present study was to evaluate the quality of care and outcome in patients with acute coronary syndrome (ACS) according to international guidelines.Methods. We used data from the Gulf Registry of Acute Coronary Events (Gulf RACE). A sub sample of 1693 patients from the United Arab Emirates (UAE) was analyzed.Results. In all ACS patients, aspirin and statins were adequately prescribed on admission and at discharge, whereas, the treatment with an- giotensin-converting enzyme inhibitor (ACEI)/ angiotensin II receptor blocker (ARIIB), clopi- dogrel, and beta-blockers (BB), increased at discharge according to guideline-recommend- ed treatment. The use of clopidogrel and BB at discharge was significantly different in the three ACS classes. Patients who were receiving all five guideline-recommended drugs, were mainly males (P=0.0001) and more in the age groups of (< 55 and 55-74 years). Smokers were better treated than non-smokers, but patients with prior coronary artery disease (CAD) did not receive optimal treatment. Mortality was significantly (P=0.0001) less among the subjects who received adequate treatment (0.1%) than those who did not (4.3%). Multivariate regression analysis, showed that age [adjusted OR: 1.051; 95% CI: 1.015-1.089; P=0.0051 and the use of all five guideline-rec- ommend drugs [adjusted OR: 0.042; 95% CI: 0.005-0.319; P=0.002 (protective effect)! were independent predictors of death.Conclusion. The quality of care for patients with ACS in the UAE seems to be modest and the use of guideline-recommended drugs is suboptimal. The need for improved care, particularly, among elder patients, and adherence to guideline-recommended treatment is highlighted.

KW - Acute coronary syndrome

KW - Coronary vessels

KW - Quality of health care

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