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Year : 2009  |  Volume : 10  |  Issue : 3  |  Page : 104-109

Determinants of in-hospital cardiac catheterization in acute coronary syndrome patients in Kuwait

1 Department of Medicine, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait
2 Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait
3 Associate Professor of Clinical Epidemiology, School of Population Health, University of Queensland, Herston, Australia

Correspondence Address:
Mohammad Zubaid
Department of Medicine, Kuwait University, P.O. Box 24923, Safat 13110
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Source of Support: None, Conflict of Interest: None

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Objective: Clinical trials and practice guidelines have established the efficacy of early invasive strategy for high risk acute coronary syndrome (ACS) patients. This analysis was undertaken to detect the predictors of in-hospital cardiac catheterization (prior to hospital discharge) in patients with ACS in Kuwait and to assess if this use of early catheterization was according to published guidelines. Methods: We analyzed data from a prospective registry of 2054 consecutive patients admitted to all 7 general hospitals in Kuwait with the diagnosis of ACS over a period of 6 months in 2004. Results : Citizens were more likely to receive in-hospital catheterization than expatriates (52.1% vs 38.6%; odds ratio 1.7; 95% confidence interval [CI], 1.4 to 2.2; p < 0.001). Patients with recurrent ischemia were more likely to undergo in-hospital catheterization than patients without recurrent ischemia (55.9% vs 12.2%; odds ratio 11.2; 95% CI, 8.6 to 14.5; p < 0.001). Two coronary artery disease risk factors (hyperlipidemia and positive family history) were associated with high rate of in-hospital cardiac catheterization (respectively, odds ratio 1.3; 95% CI, 1.2 to 2; p < 0.001 and odds ratio 1.5; 95% CI, 1.3 to 2.3; p < 0.001). Conclusion: Although high risk patients benefit the most from an early invasive strategy after ACS, this strategy was persevered for those with recurrent ischemia and citizens. Other risk factors were not determinants for in-hospital cardiac catheterization. Thus, there is substantial opportunity to improve the use of this effective therapy in high risk patients.

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