Bleeding complications with acute coronary syndrome in six Middle Eastern countries

• Published in: Acta Cardiologica 2011-04, Vol.66 (2), p.203-211
• Main Authors: Shakir, Douraid K., Zubaid, Mohammad, Al-Mallah, Mouaz H., Al-Mahmeed, Wael, Alsheikh-Ali, Alawi A., Singh, Rajvir, Amin, Haitham, Rao, Nayan, Al Suwaidi, Jassim
• Format: Article
• Language: English
• Subjects: acute coronary syndrome; Acute Coronary Syndrome - complications; Acute Coronary Syndrome - therapy; Aged; Bleeding; Chi-Square Distribution; elevation myocardial infarction; Female; Hemorrhage - epidemiology; Hemorrhage - etiology; Hemorrhage - therapy; Hospital Mortality; Humans; Logistic Models; Male; Middle East - epidemiology; non-ST-segment; Prevalence; Prognosis; Prospective Studies; Registries; Risk Factors; ST-segment elevation myocardial infarction; Statistics, Nonparametric
• ISSN: 0001-5385; 0373-7934
• DOI: 10.1080/AC.66.2.2071252

Objective Little is known about the prevalence and prognostic implications of major bleeding complications among patients admitted with acute coronary syndrome (ACS) in the Middle East. We describe the prevalence and outcome of ACS in Middle Eastern patients with and without major bleeding complications. Methods The Gulf Registry of Acute Coronary Events (Gulf RACE) is a prospective, multinational registry conducted for 6 months in 2007 for patients hospitalized with the fi nal diagnosis of ACS in 65 centres in six adjacent Middle Eastern countries. There were no exclusion criteria. A total of 8166 patients were stratifi ed according to the development of major bleeding complications during the index admission. Results Compared to patients without bleeding complications, patients with major bleeding (68 patients, 0.83%) were signifi cantly older, and had ST-segment elevation myocardial infarction. However, there were no signifi cant diff erences between the two groups with regard to sex, other cardiovascular risk factors, or use of antiplatelet and antithrombotic therapy. Patients with bleeding complications had worse in-hospital outcomes including death, congestive heart failure, cardiogenic shock, recurrent myocardial infarction, and stroke. After adjusting for baseline characteristics, major bleeding was independently associated with a more than 5-fold increase in in-hospital mortality (odds ratio 5.2, 95% confi dence interval 2.8-10.1, P < 0.001). Conclusion Similar to Western studies, bleeding in the setting of ACS is a powerful and independent predictor of poor in-hospital outcomes in patients admitted with ACS in the Middle East.