Percutaneous Coronary Intervention Vs Coronary Artery Bypass Surgery for Unprotected Left Main Coronary Disease: G-LM Registry

Coronary artery bypass surgery (CABG) has been the standard of care for revascularization for patients with obstructive unprotected left main coronary disease (ULMCA). There have been multiple randomized and registry data demonstrating the technical and clinical efficacy of PCI in certain patients with ULMCA. The purpose of this study is to evaluate clinical outcomes of ULMCA PCI as compared to CABG in patients requiring revascularization in three Gulf countries. All ULMCA cases treated by PCI with DES versus CABG were retrospectively identified from 14 centers in 3 Arab Gulf countries (KSA, UAE, and Bahrain) from January 2015 to December 2019. In total, 2138 patients were included: 1222 were treated with PCI versus 916 with CABG. Patients undergoing PCI were older, and had higher comorbidities and mean European System for Cardiac Operative Risk Evaluation (EuroSCORE). Aborted cardiac arrest and cardiogenic shock were reported more in the PCI group at hospital presentation. In addition, lower ejection fractions were reported in the PCI group. In hospital mortality and major adverse cardiovascular and cerebrovascular events (MACCE) occurred more in patients undergoing CABG than PCI. At median follow-up of 15 months (interquartile range, 30), no difference was observed in freedom from revascularization, MACCE, or total mortality between those treated with PCI and CABG. While findings are similar to Western data registries, continued follow-up will be needed to ascertain whether this pattern continues into latter years.

Public Trust and Compliance with the Precautionary Measures Against COVID-19 Employed by Authorities in Saudi Arabia

BACKGROUND

The newly emerged and highly infectious coronavirus disease (COVID-19), which first broke out in Wuhan, China, has invaded most countries around the globe. As both the daily positive cases and death toll increase, countries have taken aggressive action to halt its spread. Saudi Arabia recognized the danger early and implemented a series of urgent precautions. Thus, this study aims to evaluate public trust and compliance with the precautionary measures implemented by authorities to combat the COVID-19 outbreak.

METHODS

A cross-sectional study was conducted on a sample of the Saudi public using an electronic questionnaire during the COVID-19 outbreak. The data, which were collected using a validated public trust and compliance tool, were analyzed using the chi-square test, t test, and binary logistic regression.

FINDINGS

Of the 1232 participants, there were 655 (53.2%) males and 577 (46.8%) females with 34 ± 10 years as the mean and standard deviation of their age. Participants demonstrated a high level of trust and agreement (98.2%) with the implemented precautionary measures. A positive association between participants' age and their level of agreement with the government actions (r=-.082, P=0.004) was observed, with a significant difference between males (97.1±6.2) and females (98.0±4.7) (t=-2.7, P=0.006). Among the participants, 657 (53.3%) were considered to be practicing poor precautionary measures and 575 (46.7%) good precautionary measures. Males (OR=1.8 times, P<0.001) and those with a school education level (OR=1.7 times, P=0.002) were more likely to have poor precautionary practices compared to others. Married individuals (369, 49.0%; P=0.04) were more likely to comply with good practices.

CONCLUSION

A high level of trust was exhibited by the Saudi public in relation to the precautionary measures taken by authorities in Saudi Arabia. Gender, age, marital status, and educational level were found to be significant factors with regard to compliance with precautionary practices.