Impact of Revascularization on Major Adverse Cardiovascular Events in Patients Without ST-Elevation Myocardial Infarction in the Arabian Gulf

TL;DR

This study shows that revascularization procedures like PCI or CABG reduce major cardiovascular risks in NSTEMI patients in the Arabian Gulf.

Contribution

The study provides region-specific evidence on the effectiveness of revascularization in reducing MACE in NSTEMI patients.

Findings

PCI/CABG reduced MACE events from 43% to 25% compared to non-revascularized patients.

Significant reductions were observed in stroke/TIA and cardiac readmissions.

No significant difference was found in reinfarction rates between groups.

Abstract

Objectives: The study evaluated the impact of revascularization procedures, including percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG), during the index hospitalization on major adverse cardiovascular events (MACE) in patients with non-ST-elevation myocardial infarction (NSTEMI) in the Arabian Gulf. Methods: Data were analyzed from 1820 consecutive patients diagnosed with NSTEMI, admitted to 29 hospitals in four Arabian Gulf countries from January 2012 to January 2013, and who were discharged alive. Results: Of the patients, 29.1% (n = 529) underwent either PCI (89.8%; n = 475) or CABG (10.2%; n = 54). The matching method (288 PCI/CABG patients were matched with 762 controls that did not undergo PCI/CABG) revealed significant reductions in MACE events among patients who had undergone PCI/CABG (25% vs. 43%; p < 0.001). This decrease was consistent across individual MACE components, including stroke/transient ischemic attack (TIA) (2.4% vs. 7.0%; p = 0.005), all-cause mortality (4.5% vs. 7.0%; p < 0.001) and cardiac-related readmissions (20% vs. 31%; p = 0.001) but not reinfarction (1.7% vs. 1.4%; p = 0.73). Conclusions: The revascularization procedures, PCI/CABG, were associated with significant reductions in annual MACE event rates, specifically lower stroke/TIA, all-cause mortality and cardiac-related readmissions.

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