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Publications (4)3.59 Total impact

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    ABSTRACT: AIM: Objective of the present study was to evaluate the quality of care and outcome in patients with acute coronary syndrome (ACS) according to international guidelines. METHODS: We used data from the Gulf Registry of Acute Coronary Events (Gulf RACE). A sub sample of 1693 patients from the United Arab Emirates (UAE) was analyzed. RESULTS: In all ACS patients, aspirin and statins were adequately prescribed on admission and at discharge, whereas, the treatment with angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARIIB), clopidogrel, and beta-blockers (BB), increased at discharge according to guideline-recommended treatment. The use of clopidogrel and BB at discharge was significantly different in the three ACS classes. Patients who were receiving all five guideline-recommended drugs, were mainly males (P=0.0001) and more in the age groups of (< 55 and 55-74 years). Smokers were better treated than non-smokers, but patients with prior coronary artery disease (CAD) did not receive optimal treatment. Mortality was significantly (P=0.0001) less among the subjects who received adequate treatment (0.1%) than those who did not (4.3%). Multivariate regression analysis, showed that age [adjusted OR: 1.051; 95% CI: 1.015-1.089; P=0.005] and the use of all five guideline-recommend drugs [adjusted OR: 0.042; 95% CI: 0.005-0.319; P=0.002 (protective effect)] were independent predictors of death. CONCLUSION: The quality of care for patients with ACS in the UAE seems to be modest and the use of guideline-recommended drugs is suboptimal. The need for improved care, particularly, among elder patients, and adherence to guideline-recommended treatment is highlighted.
    Gazzetta medica italiana 07/2014; 173(7-8):377-82.
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    ABSTRACT: We describe the baseline characteristics, management, and in-hospital outcomes of patients in the United Arab Emirates (UAE) with DM admitted with an acute coronary syndrome (ACS) and assess the influence of DM on in-hospital mortality. Data was analyzed from 1697 patients admitted to various hospitals in the UAE with a diagnosis of ACS in 2007 as part of the 1st Gulf RACE (Registry of Acute Coronary Events). Of 1697 patients enrolled, 668 (39.4%) were diabetics. Compared to patients without DM, diabetic patients were more likely to have a past history of coronary artery disease (49.1% versus 30.1%, P < 0.001), hypertension (67.2% versus 36%, P < 0.001), and prior revascularization (21% versus 11.4%, P < 0.001). They experienced more in-hospital recurrent ischemia (8.5% versus 5.1%; P = 0.004) and heart failure (20% versus 10%; P < 0.001). The mortality rate was 2.7% for diabetics and 1.6% for nondiabetics (P = 0.105). After age adjustment, in-hospital mortality increased by 3.5% per year of age (P = 0.016). This mortality was significantly higher in females than in males (P = 0.04). ACS patients with DM have different clinical characteristics and appear to have poorer outcomes.
    The Scientific World Journal 06/2012; 2012:698597. DOI:10.1100/2012/698597 · 1.22 Impact Factor
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    ABSTRACT: Gender differences exist in many aspects of acute coronary syndrome (ACS), including presentation and delay in diagnosis and treatment. The aim of the study was to evaluate gender-related differences in ACS patients in the United Arab Emirates (UAE). We analyzed a subset (n = 1697) of the Gulf Registry of Acute Coronary Events (Gulf RACE) data collected in 2007 of patients with ACS from 18 UAE hospitals. Women were significantly older (mean age: 64.0 ± 12.4 years for females and 50.9 ± 10.6 years for males, P < .001), more often had cardiac risk factors and were significantly less treated with β-blockers and reperfusion therapy. The adjusted mortality rate of women was 4.6% versus 1.2% in men (P < .001). Heart failure was higher in females compared with men (24.6% vs 12.5%; P < .001). Reasons for the high in-hospital mortality in women need to be investigated further.
    Angiology 05/2012; 64(1). DOI:10.1177/0003319712443891 · 2.37 Impact Factor
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    ABSTRACT: To evaluate clinical profiles, management and in-hospital outcomes of acute coronary syndrome (ACS) patients with metabolic syndrome (MetS) in the United Arab Emirates (UAE). MetS was defined according to the criteria for its diagnosis by the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI). Participants were admitted to various hospitals in the UAE with a diagnosis of ACS in 2007 as part of the Gulf Registry of Acute Coronary Events (Gulf RACE) project. We compared baseline characteristics, treatment patterns, and in-hospital outcomes stratified by MetS status. Of 1259 patients with ACS in the UAE (mean age: 52 ± 11 years, 88.8% males), the majority (n = 851, 67.6%) had MetS. MetS patients were more frequently males (86.4 vs 13.6%; P < 0.001). They were more obese (waist circumference and BMI, P < 0.001) as compared with non-MetS patients. MetS was more frequently associated with hypertension (51.1 vs 37.7%; P < 0.001) and diabetes mellitus (45.6 vs 24.3%; P < 0.001). After multivariate adjustment, certain MetS criteria rather than MetS itself were associated with higher in-hospital mortality and heart failure. Paradoxically, hypertension was associated with lower in-hospital mortality. Prevalence of MetS among patients with ACS in our study population was high. Certain MetS criteria were associated with higher in-hospital mortality and heart failure.
    The Open Cardiovascular Medicine Journal 01/2012; 6:81-7. DOI:10.2174/1874192401206010081