Key result
High-risk patients with non-ST-elevation ACS were less likely to undergo in-hospital cardiac catheterization compared to low-risk patients.
Why the study?
What are the utilization rates and determinants of in-hospital cardiac catheterization in patients with acute coronary syndrome in the Middle East?
Cohort (n=8,150)
Yes
What are the utilization rates and determinants of in-hospital cardiac catheterization in patients with acute coronary syndrome in the Middle East?
In the Middle East, in-hospital cardiac catheterization for ACS is underutilized (20%) and paradoxically performed less frequently in high-risk patients compared to low-risk patients.
Answers are grounded in this paper and cite their sources.
High-risk NSTE-ACS patients less likely to receive catheterization; hypothesis-generating for targeted quality initiatives in Middle Eastern cohorts.
We assessed the use and determinants of cardiac catheterization during index admissions, among patients with acute coronary syndrome (ACS) in the Middle East. Data were analyzed from 8150 consecutive ACS patients enrolled prospectively. The overall rate of cardiac catheterization was 20%. Major predictors of cardiac catheterization were university hospitals, hospitals with catheterization facilities, physician type, and Gulf citizenship. High-risk patients were catheterized less compared to low-risk patients; odds ratio (OR) 0.44, 95% confidence interval (CI): 0.33-0.60, P < .001 and OR 0.68, 95% CI: 0.48-0.98, P = .037 for patients with non-ST-elevation ACS and ST-elevation myocardial infarction, respectively. The use of cardiac catheterization in patients with ACS from Middle East is low. It is related more to hospital characteristics than to baseline risks. There is a need to explore ways to increase overall rate of in-hospital cardiac catheterization in the region and direct it to patients who would benefit most.
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Panduranga et al. (2010) conducted a cohort in Acute coronary syndrome (ACS) (n=8,150). High-risk status vs. Low-risk status was evaluated on In-hospital cardiac catheterization (OR 0.44, 95% CI 0.33-0.60, p=<.001). High-risk patients with non-ST-elevation ACS were less likely to undergo in-hospital cardiac catheterization compared to low-risk patients.
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