Comparison of Men and Women With Acute Coronary Syndrome in Six Middle Eastern Countries

El‐Menyar, Ayman; Zubaid, Mohammad; Rashed, Wafa; Almahmeed, Wael; Al-Lawati, Jawad; Sulaiman, Kadhim; Al‐Motarreb, Ahmed; Amin, Haitham; Singh, Rajvir; Suwaidi, Jassim Al

doi:10.1016/j.amjcard.2009.06.003

Cited by 100 publications

(75 citation statements)

References 21 publications

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“…9,10 From January 29, 2007, through July 29, 2007, 8176 consecutive patients with ACS were recruited from 64 hospitals in 6 Middle Eastern countries (Bahrain, Kuwait, Qatar, Oman, United Arab Emirates, and Yemen). Figure 1 shows the Gulf RACE design for the current analysis.…”

Section: Methodsmentioning

confidence: 99%

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In-hospital Major Clinical Outcomes in Patients With Chronic Renal Insufficiency Presenting With Acute Coronary Syndrome: Data From a Registry of 8176 Patients

El‐Menyar

Zubaid

Sulaiman

et al. 2010

Mayo Clinic Proceedings

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C hronic renal insufficiency (CRI) is a well-established risk factor and predictor of mortality in patients with coronary artery disease. [1][2][3][4][5][6][7][8] However, the impact of varying stages of CRI in patients with the entire acute coronary syndrome (ACS) spectrum has been less extensively studied. In-hospital Major Clinical Outcomes in Patients With RESULTS:Of 6518 consecutive patients with ACS, 2828 (43%) had mild CRI, 1304 (20%) had moderate CRI, and 345 (5%) had severe CRI. In CRI groups, patients were older and had a higher prevalence of hypertension, diabetes mellitus, and dyslipidemia. On admission, these patients had a higher resting heart rate and frequently had atypical and delayed presentations. Compared with the normal estimated glomerular filtration group, CRI groups were less likely to receive antiplatelet drugs, β-blockers, angiotensinconverting enzyme inhibitors, and statins and were less likely to undergo coronary angiography. In-hospital heart failure, cardiogenic shock, and major bleeding episodes were significantly higher in all CRI groups. In multivariate analysis, mild, moderate, and severe CRI were associated with a higher adjusted odds ratio (OR) of death (mild: OR, 2.1; 95% confidence interval [CI], 1.2-3.7; moderate: OR, 6.7; 95% CI, 3.9-11.5; and severe: OR, 12.0; 95% CI, 6.6-21.7).CONCLUSION: Across the ACS spectrum, patients with CRI had a worse risk profile, had more atypical and delayed presentations, and were less likely to receive evidence-based therapy. Chronic renal insufficiency of varying stages is an independent predictor of in-hospital morbidity and mortality.Mayo Clin Proc. 2010;85(4):332-340 ACS = acute coronary syndrome; CI = confidence interval; CrCl = creatinine clearance; CRI = chronic renal insufficiency; eGFR = estimated glomerular filtration rate; GRACE = Global Registry of Acute Coronary Events; Gulf RACE = Gulf Registry of Acute Coronary Events; MACE = major adverse cardiac event; NSTACS = non-ST-segment elevation ACS; OR = odds ratio; S Cr = serum creatinine; STEMI = ST-segment elevation myocardial infarctionThe objective of the current study was to evaluate the prognostic impact of the CRI stages on the in-hospital mortality and major adverse cardiac events (MACEs) across the ACS population, including patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTACS).

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Section: Methodsmentioning

confidence: 99%

“…1,10 The GRACE risk models for hospital mortality were used to stratify the risk status of patients at presentation as low, intermediate, or high.…”

Section: Statistical Analysesmentioning

confidence: 99%

In-hospital Major Clinical Outcomes in Patients With Chronic Renal Insufficiency Presenting With Acute Coronary Syndrome: Data From a Registry of 8176 Patients

El‐Menyar

Zubaid

Sulaiman

et al. 2010

Mayo Clinic Proceedings

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“…Full details of the methods have been published previously. 13,14 Diagnosis of the different types of ACS and definitions of data variables were based on the American College of Cardiology clinical data standards. 15 History of khat chewing was recorded at the time of presentation.…”

Section: Methodsmentioning

confidence: 99%

Association of Khat Chewing With Increased Risk of Stroke and Death in Patients Presenting With Acute Coronary Syndrome

Ali

Zubaid

Al‐Motarreb

et al. 2010

Mayo Clinic Proceedings

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Objective: To evaluate the prevalence and significance of khat chewing in patients with acute coronary syndrome (ACS). From January 29, 2007, through July 29, 2007 consecutive patients presenting with ACS were enrolled in a prospective, multicenter study from 6 adjacent Middle Eastern countries. Patients and MethOds:Results: Of the 8176 study patients, 7242 (88.6%) were nonkhat chewers, and 934 (11.4%) were khat chewers, mainly of Yemeni origin. Khat chewers were older (57 vs 56 years; p=.01) and more likely to be men (85.7% vs 74.5%) compared with non-khat chewers. Non-khat chewers were more likely to have diabetes mellitus, hypertension, dyslipidemia, obesity, and prior history of coronary artery disease and revascularization. Cigarette smoking was more prevalent in khat chewers, and they were more likely to present greater than 12 hours after onset of symptoms compared with non-khat chewers. At admission, khat chewers had higher heart rate, Killip class, and Global Registry of Acute Coronary Events risk scores. Khat chewers had a significantly higher risk of cardiogenic shock, stroke, and mortality. After adjustment of baseline variables, khat chewing was an independent risk factor for in-hospital mortality (odds ratio, 1.9; 95% confidence interval, 1.3-2.7; p<.001) and stroke (odds ratio, 2.7; 95% confidence interval, 1.3-5.9; p=.01).cOnclusiOn: In this large cohort of patients with ACS, khat chewing was prevalent and was associated with increased risk of stroke and death. In the context of increasing global migration, a greater awareness of potential widespread practices is essential. Mayo

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“…Full details of the methods have been published. [22][23][24] Diagnosis of the different types of ACS and definitions of data variables were based on the American College of Cardiology (ACC) clinical data standards. 25 -26 Recruitment in the pilot phase started on May 8, 2006, and continued for 30 days.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Prognosis of Chronic Obstructive Pulmonary Disease Among 8167 Middle Eastern Patients With Acute Coronary Syndrome

Hadi

Zubaid²,

Mahmeed

et al. 2010

Clinical Cardiology

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Background: The purpose of this study was to report the prevalence and the significance of clinically recognized chronic obstructive pulmonary disease (COPD) during acute coronary syndrome (ACS). Hypothesis: COPD in patients with ACS is associated with worse outcome. Methods: Data were derived from a prospective, multicenter, multinationalstudy of 8167 consecutive patients hospitalized with ACS from February to June 2007 in 6 Middle Eastern countries. Data were analyzed according to the presence or absence of COPD. Demographic, management, and in-hospital outcomes were compared. Results: The prevalence of COPD was 5.3%. When compared with non-COPD patients, COPD patients were older and more likely to have diabetes, hypertension, and dyslipidemia. Atypical presentations were more common in COPD patients (P = 0.001). COPD patients were less likely to be treated with thrombolytic therapy (P = 0.001), β-blockers (P = 0.001), and glycoprotein IIb/IIIa inhibitors, and more likely to receive angiotensin-converting enzyme (ACE) inhibitors. Although there was no difference in in-hospital mortality between the 2 groups, patients with COPD were more likely to have heart failure (P = 0.001). Despite the fact that COPD patients with ST-segment elevation myocardial infarction were less likely to receive thrombolytic therapy, they suffered more bleeding complications (2.8% vs 1%, P = 0.04), resulting in prolonged hospitalization. COPD was not an independent predictor of increased in-hospital mortality. Conclusions: In this large cohort of patients with ACS, the prevalence of COPD was 5·3%. Atypical presentation is common among COPD patients, and this may result in delayed therapy. ACS in COPD patients was associated with higher risk of heart failure and major bleeding complications without increased risk of in-hospital mortality.

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Comparison of Men and Women With Acute Coronary Syndrome in Six Middle Eastern Countries

Cited by 100 publications

References 21 publications

In-hospital Major Clinical Outcomes in Patients With Chronic Renal Insufficiency Presenting With Acute Coronary Syndrome: Data From a Registry of 8176 Patients

In-hospital Major Clinical Outcomes in Patients With Chronic Renal Insufficiency Presenting With Acute Coronary Syndrome: Data From a Registry of 8176 Patients

Association of Khat Chewing With Increased Risk of Stroke and Death in Patients Presenting With Acute Coronary Syndrome

Prevalence and Prognosis of Chronic Obstructive Pulmonary Disease Among 8167 Middle Eastern Patients With Acute Coronary Syndrome

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