ArticleClinical cardiology2010
Missed opportunities in the management of ST-segment elevation myocardial infarction in the Arab Middle East: patient and physician impediments.
Article in Clinical cardiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Atypical Presentations at Risk for Diagnostic Errors in Internal Medicine: A Scoping Review.Journal of general internal medicine · 2026Article
- Predictors of delayed pre-hospital presentation among patients with ST-segment elevation myocardial infarction.Qatar medical journal · 2016Article
- Stent Thrombosis after Rescue Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction.The open cardiovascular medicine journal · 2015Article
- Risk factors, therapeutic approaches, and in-hospital outcomes in Mexicans with ST-elevation acute myocardial infarction: the RENASICA II multicenter registry.Clinical cardiology · 2013Article
- Factors associated with presenting >12 hours after symptom onset of acute myocardial infarction among Veteran men.BMC cardiovascular disorders · 2012Article
- Primary coronary intervention versus thrombolytic therapy in myocardial infarction patients in the Middle East.International journal of clinical pharmacy · 2012Article
- 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.Journal of the Saudi Heart Association · 2011Article
- Quality of care in primary percutaneous coronary intervention for acute ST-segment -elevation myocardial infarction: Gulf RACE 2 experience.Annals of Saudi medicineArticle
- Baseline characteristics, management practices, and long-term outcomes of Middle Eastern patients in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-2).Annals of Saudi medicineArticle
- Disparity in ST-segment Elevation Myocardial Infarction Practices and Outcomes in Arabian Gulf Countries (Gulf COAST Registry).Heart views : the official journal of the Gulf Heart AssociationArticle
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9 authors.
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Abstract
backgroundLack of timely reperfusion therapy in patients with ST-elevation myocardial infarction (STEMI) has been associated with worse outcomes. The aim of this study is to identify the frequency and predictors of delayed presentation and missed reperfusion in patients with STEMI in the Gulf Register of Acute Coronary Events (Gulf RACE) registry. Delayed Presentation and missed reperfusion is associated with increased in hospital mortality in STEMI patients.
methodsGulf RACE is a prospective, multinational study of all consecutive patients hospitalized with the final diagnosis of acute coronary syndrome in 65 centers in 6 Arab countries. In this analysis, we included 3197 patients with STEMI. The independent predictors of delayed presentation and missed reperfusion therapy were identified using multivariate logistic regression.
resultsIn total, 929 patients presented > 12 hours after symptom onset. The independent predictors of late presentation are older age, atypical symptoms, no family history of coronary artery disease, and being in Yemen. Of the 2268 STEMI patients presenting early, a total of 205 patients (9.3%) did not receive reperfusion therapy despite no contraindications (shortfall). The independent predictors of not receiving appropriate reperfusion therapy are older age, prior stroke, being in Yemen, and atypical symptoms. Lack of reperfusion therapy due to shortfall or delayed presentation was associated with increased in-hospital mortality.
conclusionsNearly one-third of patients with STEMI in the Arab Middle East present to the hospital > 12 hours after symptom onset, and nearly 1 in 10 eligible patients do not receive any reperfusion therapy. Community and physician awareness programs are needed to increase the utilization of appropriate lifesaving therapies.
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