Baseline Characteristics, Management Practices, and Long-term Outcomes Among Patients with First Presentation Acute Myocardial Infarction in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-II)

Overview

Journal J Saudi Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2018 Jul 10

PMID 29983497

Citations 2

Authors

Abdulaziz U Joury

Ahmed S Hersi

Hussam AlFaleh

Khalid F Alhabib

Tarek Seifaw Kashour

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Limited data are available highlighting the different clinical aspects of acute coronary syndrome (ACS) patients, especially in Gulf countries. In this study, we aimed to compare patients who presented with acute myocardial infarction (AMI) as the first presentation of patients who have a history of ACS in terms of initial presentation, medical history, laboratory findings, and overall mortality.

Methods: We used the Second Gulf Registry of Acute Coronary Events (Gulf RACE-II), which is a multinational observational study of 7930 ACS patients.

Results: Among all patients, 4723 (59.6%) patients presented with AMI. First presentation AMI patients were older (mean age, 55 years vs. 53 years;  < 0.001) and had lower risk factors than patients with a history of ACS. Higher laboratory readings of cardiac markers and all aspects of mortality were significantly higher among patients with first presentation AMI. After adjustments for baseline variables, congestive heart failure [odds ratio (OR) = 1.08; 95% confidence interval (CI), 0.73-1.57], reinfarction (OR = 1.16; 95% CI, 0.58-2.30), cardiogenic shock (OR = 1.51; 95% CI, 0.74-3.08), stroke (OR = 2.30; 95% CI, 0.29-17.99), and overall mortality (OR = 1.16; 95% CI = 0.74-1.83) were independent predictive factors for first presentation AMI.

Conclusions: First presentation AMI patients tend to be older and to have lower rates of risk factors. Adverse clinical outcomes such as congestive heart failure, reinfarction, cardiogenic shock, and stroke were higher among patients with first presentation AMI compared to patients with a history of ACS.

Citing Articles

Psychological impact of first admission with cardiovascular disease in a tertiary hospital in Oman.

Al-Maskari A, Al-Zaabi G, Al-Mamari H, Al-Mawali M, Nadar S J Taibah Univ Med Sci. 2023; 19(1):28-34.

PMID: 37868102 PMC: 10585295. DOI: 10.1016/j.jtumed.2023.08.008.

Long-Term Predictors of Hospitalized Reinfarction after an Incident Acute Myocardial Infarction.

Schmitz T, Harmel E, Heier M, Peters A, Linseisen J, Meisinger C Life (Basel). 2022; 12(12).

PMID: 36556454 PMC: 9784794. DOI: 10.3390/life12122090.

References

Cannon C, Battler A, Cox J, Every N, Flaherty J, Harrington R . American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes. A report of the American College of Cardiology Task Force on Clinical Data Standards.... J Am Coll Cardiol. 2001; 38(7):2114-30. DOI: 10.1016/s0735-1097(01)01702-8. View

Shehab A, Al-Dabbagh B, Alhabib K, Alsheikh-Ali A, Almahmeed W, Sulaiman K . Gender disparities in the presentation, management and outcomes of acute coronary syndrome patients: data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2). PLoS One. 2013; 8(2):e55508. PMC: 3566183. DOI: 10.1371/journal.pone.0055508. View

Rogers W, Canto J, LAMBREW C, Tiefenbrunn A, Kinkaid B, Shoultz D . Temporal trends in the treatment of over 1.5 million patients with myocardial infarction in the US from 1990 through 1999: the National Registry of Myocardial Infarction 1, 2 and 3. J Am Coll Cardiol. 2000; 36(7):2056-63. DOI: 10.1016/s0735-1097(00)00996-7. View

Canto J, Kiefe C, Rogers W, Peterson E, Frederick P, French W . Atherosclerotic risk factors and their association with hospital mortality among patients with first myocardial infarction (from the National Registry of Myocardial Infarction). Am J Cardiol. 2012; 110(9):1256-61. PMC: 4494670. DOI: 10.1016/j.amjcard.2012.06.025. View

Zubaid M, Rashed W, Al-Khaja N, Almahmeed W, Al-Lawati J, Sulaiman K . Clinical presentation and outcomes of acute coronary syndromes in the gulf registry of acute coronary events (Gulf RACE). Saudi Med J. 2008; 29(2):251-5. View

Flores-Solis L, Hernandez-Dominguez J . Cardiac troponin I in patients with chronic kidney disease stage 3 to 5 in conditions other than acute coronary syndrome. Clin Lab. 2014; 60(2):281-90. DOI: 10.7754/clin.lab.2013.121103. View

Zubaid M, Rashed W, Almahmeed W, Al-Lawati J, Sulaiman K, Al-Motarreb A . Management and outcomes of Middle Eastern patients admitted with acute coronary syndromes in the Gulf Registry of Acute Coronary Events (Gulf RACE). Acta Cardiol. 2009; 64(4):439-46. DOI: 10.2143/AC.64.4.2041607. View

Damman P, Beijk M, Kuijt W, Verouden N, van Geloven N, Henriques J . Multiple biomarkers at admission significantly improve the prediction of mortality in patients undergoing primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2010; 57(1):29-36. DOI: 10.1016/j.jacc.2010.06.053. View

Bassand J, Hamm C, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F . Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J. 2007; 28(13):1598-660. DOI: 10.1093/eurheartj/ehm161. View

10.

Coventry L, Finn J, Bremner A . Sex differences in symptom presentation in acute myocardial infarction: a systematic review and meta-analysis. Heart Lung. 2011; 40(6):477-91. DOI: 10.1016/j.hrtlng.2011.05.001. View

11.

Swap C, Nagurney J . Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA. 2005; 294(20):2623-9. DOI: 10.1001/jama.294.20.2623. View

12.

Galinski M, Saget D, Ruscev M, Gonzalez G, Ameur L, Lapostolle F . Chest pain in an out-of-hospital emergency setting: no relationship between pain severity and diagnosis of acute myocardial infarction. Pain Pract. 2014; 15(4):343-7. DOI: 10.1111/papr.12178. View

13.

Giannitsis E, Katus H . Cardiac troponin level elevations not related to acute coronary syndromes. Nat Rev Cardiol. 2013; 10(11):623-34. DOI: 10.1038/nrcardio.2013.129. View

14.

Kirchberger I, Heier M, Kuch B, Wende R, Meisinger C . Sex differences in patient-reported symptoms associated with myocardial infarction (from the population-based MONICA/KORA Myocardial Infarction Registry). Am J Cardiol. 2011; 107(11):1585-9. DOI: 10.1016/j.amjcard.2011.01.040. View

15.

Mozaffarian D, Benjamin E, Go A, Arnett D, Blaha M, Cushman M . Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation. 2014; 131(4):e29-322. DOI: 10.1161/CIR.0000000000000152. View

16.

Vervueren P, Elbaz M, Wagner A, Dallongeville J, Ruidavets J, Haas B . The major element of 1-year prognosis in acute coronary syndromes is severity of initial clinical presentation: Results from the French MONICA registries. Arch Cardiovasc Dis. 2012; 105(10):478-88. DOI: 10.1016/j.acvd.2012.05.008. View

17.

Alhabib K, Hersi A, AlFaleh H, AlNemer K, AlSaif S, Taraben A . 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. J Saudi Heart Assoc. 2013; 23(4):233-9. PMC: 3727434. DOI: 10.1016/j.jsha.2011.05.004. View

18.

Aviles R, Askari A, Lindahl B, Wallentin L, Jia G, Ohman E . Troponin T levels in patients with acute coronary syndromes, with or without renal dysfunction. N Engl J Med. 2002; 346(26):2047-52. DOI: 10.1056/NEJMoa013456. View

19.

Awad H, Zubaid M, Alsheikh-Ali A, Suwaidi J, Anderson Jr F, Gore J . Comparison of characteristics, management practices, and outcomes of patients between the global registry and the gulf registry of acute coronary events. Am J Cardiol. 2011; 108(9):1252-8. DOI: 10.1016/j.amjcard.2011.06.040. View

20.

Granger C, Goldberg R, Dabbous O, Pieper K, Eagle K, Cannon C . Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003; 163(19):2345-53. DOI: 10.1001/archinte.163.19.2345. View