Alhabib Khalid F, Hersi Ahmad, Alfaleh Hussam, Alnemer Khalid, Alsaif Shukri, Taraben Amir, Kashour Tarek, Bakheet Anas, Qarni Ayed Al, Soomro Tariq, Malik Asif, Ahmed Waqar H, Abuosa Ahmed M, Butt Modaser A, Almurayeh Mushabab A, Zaidi Abdulaziz Al, Hussein Gamal A, Balghith Mohammed A, Abu-Ghazala Tareg
King Fahad Cardiac Center, King Khalid University Hospital, College of Medicine, King Saud University, Saudi Arabia.
J Saudi Heart Assoc. 2011 Oct;23(4):233-9. doi: 10.1016/j.jsha.2011.05.004. Epub 2011 Jun 1.
The Saudi Project for Assessment of Coronary Events (SPACE) registry is the first in Saudi Arabia to study the clinical features, management, and in-hospital outcomes of acute coronary syndrome (ACS) patients.
We conducted a prospective registry study in 17 hospitals in Saudi Arabia between December 2005 and December 2007. ACS patients included those with ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction and unstable angina; both were reported collectively as NSTEACS (non-ST elevation acute coronary syndrome).
5055 patients were enrolled with mean age ± SD of 58 ± 12.9 years; 77.4% men, 82.4% Saudi nationals; 41.5% had STEMI, and 5.1% arrived at the hospital by ambulance. History of diabetes mellitus was present in 58.1%, hypertension in 55.3%, hyperlipidemia in 41.1%, and 32.8% were current smokers; all these were more common in NSTEACS patients, except for smoking (all P < 0.0001). In-hospital medications were: aspirin (97.7%), clopidogrel (83.7%), beta-blockers (81.6%), angiotensin converting enzyme inhibitors/angiotensin receptor blockers (75.1%), and statins (93.3%). Median time from symptom onset to hospital arrival for STEMI patients was 150 min (IQR: 223), 17.5% had primary percutaneous coronary intervention (PCI), 69.1% had thrombolytic therapy, and 14.8% received it at less than 30 min of hospital arrival. In-hospital outcomes included recurrent myocardial infarction (1.5%), recurrent ischemia (12.6%), cardiogenic shock (4.3%), stroke (0.9%), major bleeding (1.3%). In-hospital mortality was 3.0%.
ACS patients in Saudi Arabia present at a younger age, have much higher prevalence of diabetes mellitus, less access to ambulance use, delayed treatment by thrombolytic therapy, and less primary PCI compared with patients in the developed countries. This is the first national ACS registry in our country and it demonstrated knowledge-care gaps that require further improvements.
沙特急性冠脉事件评估项目（SPACE）登记处是沙特阿拉伯首个研究急性冠脉综合征（ACS）患者临床特征、治疗及住院结局的机构。
2005年12月至2007年12月期间，我们在沙特阿拉伯的17家医院开展了一项前瞻性登记研究。ACS患者包括ST段抬高型心肌梗死（STEMI）、非ST段抬高型心肌梗死和不稳定型心绞痛患者；后两者统称为NSTEACS（非ST段抬高型急性冠脉综合征）。
共纳入5055例患者，平均年龄±标准差为58±12.9岁；男性占77.4%，沙特籍占82.4%；41.5%为STEMI患者，5.1%通过救护车送至医院。58.1%有糖尿病史，55.3%有高血压史，41.1%有高脂血症，32.8%为现吸烟者；除吸烟外，所有这些情况在NSTEACS患者中更为常见（所有P<0.0001）。住院用药情况为：阿司匹林（97.7%）、氯吡格雷（83.7%）、β受体阻滞剂（81.6%）、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（75.1%）和他汀类药物（93.3%）。STEMI患者从症状发作到入院的中位时间为150分钟（四分位间距：223），17.5%接受了直接经皮冠状动脉介入治疗（PCI），69.1%接受了溶栓治疗，14.8%在入院后30分钟内接受了溶栓治疗。住院结局包括再发心肌梗死（1.5%）、再发缺血（12.6%）、心源性休克（4.3%）、卒中（0.9%）、大出血（1.3%）。住院死亡率为3.0%。
与发达国家患者相比，沙特阿拉伯的ACS患者发病年龄较轻，糖尿病患病率更高，使用救护车的机会更少，溶栓治疗延迟，直接PCI治疗更少。这是我国首个全国性的ACS登记研究，它显示了知识 - 治疗方面的差距，需要进一步改进。
