Authors: Ibrahim AlZakwani Amr Ali Mohammad Zubaid Prashanth Panduranga Kadhim Sulaiman Ahmed Abusham Wael Almahmeed Ahmed AlMotarreb Jassim Al Suwaidi Haitham Amin
Publish Date: 2012/02/24
Volume: 33, Issue: 3, Pages: 280-286
Abstract
Little is known about the impact of thrombolytic agents on inhospital outcomes in the Middle East The objective of this study was to evaluate the impact of thrombolytic agents on inhospital outcomes in STsegment elevation myocardial infarction STEMI patients in six Middle Eastern countries Gulf Registry of Acute Coronary Events was a prospective multinational multicentre observational survey of consecutive acute coronary syndrome patients admitted to 65 hospitals in 2006 and 2007 Out of 1765 STEMI patients admitted to hospitals within 12 h of symptoms onset 25 43 and 30 were treated with streptokinase reteplase and tenecteplase respectively Median age of the study cohort was 50 45–59 years and majority were males 89 The overall median symptom onsettopresentation and median doortoneedle times were 130 min 65–240 and 45 min 30–75 respectively Streptokinase patients had worse GRACE risk scores compared to patients who received fibrin specific thrombolytics Academic hospitals and cardiologists as admitting physicians were associated with the use of fibrin specific thrombolytics After significant covariate adjustment both reteplase odds ratio OR 038 95 CI 018–079 P = 0009 and tenecteplase OR 030 95 CI 012–077 P = 0012 were associated with lower allcause inhospital mortality compared with streptokinase No significant differences in other inhospital outcomes were noted between the thrombolytic agents In conclusion in light of the study’s limitations fibrin specific agents reteplase and tenecteplase were associated with lower allcause inhospital mortality compared to the nonspecific fibrin agent streptokinase However the type of thrombolytic agent used did not influence other inhospital outcomesGulf RACE was sponsored by the Gulf Heart Association and was financially supported by a grant from Sanofi Aventis and Qatar Telecommunications Company The financial sponsors had no role in study design data collection data analysis writing of the report or submission of the manuscript The authors declare no conflicts of interest with respect to the authorship and/or publication of this article The authors would like to thank the patients physicians nurses and support staff who participated in Gulf RACE registry for their invaluable contribution and cooperation
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