Background & hypothesis:Data on the clinical characteristics and outcome of patients presenting with acute coronary syndrome (ACS) according to their marital status is not clear.Methods:A total of 5334 patients presenting with ACS in 65 hospitals in 6 Middle East countries in the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE‐2) were studied according to their marital status (5024 married, 100 single, and 210 widowed patients).Result:When compared to married patients, widowed patients were older and more likely to be female. Widowed patients were more likely to have diabetes mellitus, hypertension, history of heart failure, and peripheral vascular disease and were less likely to be tobacco users when compared to the other groups. Widowed patients were also more likely to present with atypical symptoms and have advanced Killip class. Widowed patients were more likely to present with non‐ST‐elevation myocardial infarction (NSTEMI) when compared to the other 2 groups. Widowed patients were more likely to have heart failure (P = 0.001), cardiogenic shock (P = 0.001), and major bleeding (P = 0.002) when compared to the other groups. No statistically significant difference was observed in regard to duration of hospital stay, door to needle time in STEMI patients, or cardiac arrhythmias between the various groups. Widowed patients had higher in‐hospital, 30‐day, and 1‐year mortality rates (P = 0.001). Marital status was an independent predictor for in‐hospital mortality.Conclusion:Widowed marital status was associated with worse cardiovascular risk profile, and worse in‐hospital and 1‐year outcome. Future work should be focused on whether the provision of psychosocial support will result in improved outcomes among this high‐risk group. Clin. Cardiol. 2011 DOI: 10.1002/clc.22034Gulf RACE is a Gulf Heart Association (GHA) project and was financially supported by the GHA, Sanofi Aventis, and the College of Medicine Research Center at King Khalid University Hospital, King Saud University, and Riyadh, Saudi Arabia.The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Clinical characteristics and outcomes of ACS patients depend on the tobacco modality used. Further studies are required to evaluate the impact of emerging tobacco use modalities on patients with coronary artery disease.

Background— Atrial fibrillation (AF) is the most common serious cardiac arrhythmia, and its prevalence is expected to increase. There is lack of data about patient characteristics, practice patterns, and outcomes of AF in the Arab Middle East. Methods and Results— The Gulf Survey of Atrial Fibrillation Events (Gulf SAFE) is a prospective, observational registry of patients with AF with a 12-month follow-up. The registry was emergency room based. Between October 2009 and June 2010, 2043 consecutive patients with AF were enrolled from 23 hospitals in 6 Middle Eastern Gulf countries. Data were collected on a standardized case report form and entered online. Data collected included patient demographics, medical history, type of AF, treatment, and outcome of emergency room visit. If patients were admitted, details of their treatment, investigations, and outcomes during hospital stay were collected. Completion of 12-month follow-up is expected by July 2011. The mean age was 57 years, and 52% were men. The most common concomitant condition was hypertension, present in 1072 (52%) patients. At enrollment, 28% of patients had a history of coronary artery disease, 30% had diabetes, and 16% had rheumatic valve disease. History of stroke and transient ischemic attacks were reported in 9% and 4% of patients, respectively. The most common type of AF, first attack AF, occurred in 37%, whereas 19% of patients had lone AF. Conclusions— Gulf SAFE will provide valuable insights into AF management and outcomes in the Gulf region of the Middle East.