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Al Saleh A, Jamee A, Sulaiman K, Sobhy M, Gamra H, Alkindi F, Benkhedda S, Al-Motarreb A, Amin MI, Almahmeed W, Hammoudeh A, Skouri H, Farhan HA, Al Jarallah M, Fellat N, Panduranga P, Alnajm BK, Abdelhamid M, Refaat R, Amor H, Messaous S, Ahmed HS, Chibane A, AbdulMalek A, Alsagheer NK, Dada S, Mokhtar Z, Ali M, Ullah A, AlBackr H, Alhabib KF. Clinical features, socioeconomic status, management, short and long-term outcomes of patients with acute myocardial infarction: Phase I results of PEACE MENA registry. PLoS One 2024; 19:e0296056. [PMID: 38206951 PMCID: PMC10783754 DOI: 10.1371/journal.pone.0296056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The Program for the Evaluation and Management of Cardiac Events in the Middle East and North Africa (PEACE MENA) is a prospective registry program in Arabian countries that involves in patients with acute myocardial infarction (AMI) or acute heart failure (AHF). METHODS This prospective, multi-center, multi-country study is the first report of the baseline characteristics and outcomes of inpatients with AMI who were enrolled during the first 14-month recruitment phase. We report the clinical characteristics, socioeconomic, educational levels, and management, in-hospital, one month and one-year outcomes. RESULTS Between April 2019 and June 2020, 1377 patients with AMI were enrolled (79.1% males) from 16 Arabian countries. The mean age (± SD) was 58 ± 12 years. Almost half of the population had a net income < $500/month, and 40% had limited education. Nearly half of the cohort had a history of diabetes mellitus, hypertension, or hypercholesterolemia; 53% had STEMI, and almost half (49.7%) underwent a primary percutaneous intervention (PCI) (lowest 4.5% and highest 100%). Thrombolytics were used by 36.2%. (Lowest 6.45% and highest (90.9%). No reperfusion occurred in 13.8% of patients (lowest was 0% and highest 72.7%).Primary PCI was performed less frequently in the lower income group vs. high income group (26.3% vs. 54.7%; P<0.001). Recurrent ischemia occurred more frequently in the low-income group (10.9% vs. 7%; P = 0.018). Re-admission occurred in 9% at 1 month and 30% at 1 year, whereas 1-month mortality was 0.7% and 1-year mortality 4.7%. CONCLUSION In the MENA region, patients with AMI present at a young age and have a high burden of cardiac risk factors. Most of the patients in the registry have a low income and low educational status. There is heterogeneity among key performance indicators of AMI management among various Arabian countries.
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Affiliation(s)
- Ayman Al Saleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Amal Jamee
- Nassar Medical Complex Hospital, Ministry of Health, Khan Younes, Gaza Strip, Palestine
- Al-Quds Hospital, Gaza, Palestine
| | | | - Mohamed Sobhy
- International Cardiac Center (ICC), Alexandria, Egypt
| | - Habib Gamra
- Research Laboratory LR, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Fahad Alkindi
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Salim Benkhedda
- Cardiology Department, Mustapha Hospital, COCRG Laboratory University Benyoucef Benkhedda, Algiers, Algeria
| | | | | | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirate
| | | | - Hadi Skouri
- Cardiology Division, Internal Medicine Department at American University of Beirut Medical Center, Beirut, Lebanon
| | - Hasan A. Farhan
- Iraqi Board for Medical Specializations, Scientific Council of Cardiology. Baghdad Heart Center, Medical City, Baghdad, Iraq
| | | | | | | | | | - Magdy Abdelhamid
- Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Giza Governorate, Egypt
| | - Rafik Refaat
- International Cardiac Center (ICC), Alexandria, Egypt
| | - Hassen Amor
- Taher Sfar University Hospital, Mahdia, Tunisia
| | - Salma Messaous
- Research Laboratory LR, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | | | - Ahcene Chibane
- Internal Medicine and Cardiology Department, CHU Douéra, Algiers, University Saad Dahlab, Blida, Algeria
| | - Azzouz AbdulMalek
- Cardiology Department, Mustapha Hospital, COCRG Laboratory University Benyoucef Benkhedda, Algiers, Algeria
| | | | - Sobhi Dada
- Hammoud University Medical Center, Saida, Lebanon
| | - Zaki Mokhtar
- King Saud Hospital, Unizah, Qaseem, Saudi Arabia
| | | | - Anhar Ullah
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Hanan AlBackr
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Khalid F. Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
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Al-Maimoony T, Al-Sageer N, Bahaj S, Al-Motarreb A, Agati L. Behavior of Coronavirus pandemic in Yemen: practical experience review. Minerva Cardiol Angiol 2023; 71:653-658. [PMID: 35767238 DOI: 10.23736/s2724-5683.22.06109-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
COVID-19 is caused by a coronavirus called SARS-CoV-2, which spread, all over the world. The virus is spreading very easily and sustainably between people. Information from the ongoing pandemic disease suggests that this virus is spreading more efficiently than influenza. Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness. Coronavirus constantly changes through mutation. When a virus has one or more new mutation, it has called a variant of concern. There is no data from Yemen to show what type of coronavirus variant is spread in Yemen. We believe it is a unique situation where almost all people have been affected by the coronavirus. We tested the cardiac center workers and we found all of them have positive results. No severe symptoms among our staff were reported and many of them suffered from mild to moderate symptoms, which does not need admission to the hospital. Young age among this worker sample may explain the mild severity of COVID-19 infection detected; another explanation is the frequent exposure to viral infection in Yemen and the type of coronavirus variant in Yemen. We conducted this review to describe the current situation and our experience during the pandemic and further studies are needed to identify the exact variant in Yemen and the immunity response for this coronavirus variant in the Yemeni Society.
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Affiliation(s)
- Taha Al-Maimoony
- Cardiac Department, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Nora Al-Sageer
- Cardiac Department, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Saleh Bahaj
- Department of Microbiology and Immunology, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Ahmed Al-Motarreb
- Cardiac Department, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Luciano Agati
- Department of Cardiology, Sapienza University, Rome, Italy
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Alsaeed AH, Hersi A, Kashour T, Zubaid M, Al Suwaidi J, Amin H, AlMahmeed W, Sulaiman K, Al-Motarreb A, Alhabib KF, Alqarawi W. Characteristics and predictors of out-of-hospital cardiac arrest in young adults hospitalized with acute coronary syndrome: A retrospective cohort study of 30,000 patients in the Gulf region. PLoS One 2023; 18:e0286084. [PMID: 37228068 DOI: 10.1371/journal.pone.0286084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION The characteristics of young adults with out-of-hospital cardiac arrest (OHCA) due to acute coronary syndrome (ACS) has not been well described. The mean age of gulf citizens in ACS registries is 10-15 years younger than their western counterparts, which provided us with a unique opportunity to investigate the characteristics and predictors of OHCA in young adults presenting with ACS. METHODOLOGY This was a retrospective cohort study using data from 7 prospective ACS registries in the Gulf region. In brief, all registries included consecutive adults who were admitted with ACS. OHCA was defined as cardiac arrest upon presentation (i.e., before admission to the hospital). We described the characteristics of young adults (< 50 years) who had OHCA and performed multivariate logistic regression analysis to assess independent predictors of OHCA. RESULTS A total of 31,620 ACS patients were included in the study. There were 611 (1.93%) OHCA cases in the whole cohort [188/10,848 (1.73%) in young adults vs 423/20,772 (2.04%) in older adults, p = 0.06]. Young adults were predominantly males presenting with ST-elevation myocardial infarction (STEMI) [182/188 (96.8%) and 172/188 (91.49%), respectively]. OHCA was the sentinel event of coronary artery disease (CAD) in 70% of young adults. STEMI, male sex, and non-smoking status were found to be independent predictors of OHCA [OR = 5.862 (95% CI 2.623-13.096), OR: 4.515 (95% CI 1.085-18.786), and OR = 2.27 (95% CI 1.335-3.86), respectively]. CONCLUSION We observed a lower prevalence of OHCA in ACS patients in our region as compared to previous literature from other regions. Moreover, OHCA was the sentinel event of CAD in the majority of young adults, who were predominantly males with STEMIs. These findings should help risk-stratify patients with ACS and inform further research into the characteristics of OHCA in young adults.
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Affiliation(s)
- Abdulelah H Alsaeed
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Hersi
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Tarek Kashour
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Zubaid
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Centre, Awali, Bahrain
| | - Wael AlMahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates
| | | | - Ahmed Al-Motarreb
- Internal Medicine Department, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Khalid F Alhabib
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Wael Alqarawi
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada
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Al-Kebsi M, Al-Motarreb A, Al-Kadasi H, Al-Muqayad MH, Mangieri E, Capotosto L, Miraldi F, Mastroianni C, Vitarelli A. Peculiar clinical and diagnostic features of infective endocarditis in Yemen: Comparative analysis with a Western University Hospital. J Investig Med 2023; 71:132-139. [PMID: 36647330 DOI: 10.1177/10815589221143327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The aim of this study was to describe the pattern, characteristics, and outcomes of infective endocarditis (IE) in Yemen and compare the results with the findings of a Western university hospital. Patients (pts) with a final diagnosis of IE observed in Al-Thawra Sanaa Cardiac Center were prospectively enrolled in 1-year time period. Clinical and diagnostic findings were compared to clinical and diagnostic data of 50 pts with IE observed at Sapienza University Hospital in Rome, Italy. The mean age was 38 ± 6. Predisposing factors for IE were rheumatic heart disease (RHD) in 34 pts (68%), congenital heart disease in 9 pts (18%), prosthetic valve IE in 4 pts (8%), and previous IE in 3 pts (6%). Transthoracic echocardiography (TTE) was done in 50 pts and transesophageal echocardiography (TEE) in 25. Blood cultures were taken in all pts and were positive in 3 pts (6%) and negative in 47 (94%). TTE was positive in 34/50 pts (68%) and TEE in 20/25 (80%). Compared to Sapienza University pts, Al-Thawra Cardiac Center pts had a younger age (p = 0.003), more predisposing RHD (p = 0.0004), less prosthetic heart valves IE (p = 0.002), and more negative blood cultures (p = 0.0001). IE is still a common disease in Yemen among RHD pts and affects the younger age group. It has severe complications which need early diagnosis and proper management. Echocardiography is of prime diagnostic value in the absence of positive blood cultures. An effort should be made to prevent rheumatic fever and RHD.
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Affiliation(s)
- Mohammed Al-Kebsi
- Faculty of Medicine & Health Sciences, Sanaa University, Sanaa, Yemen
| | - Ahmed Al-Motarreb
- Faculty of Medicine & Health Sciences, Sanaa University, Sanaa, Yemen
| | | | | | - Enrico Mangieri
- Departments of Cardiology and Infectious Diseases, Sapienza University, Rome, Italy
| | - Lidia Capotosto
- Departments of Cardiology and Infectious Diseases, Sapienza University, Rome, Italy
| | - Fabio Miraldi
- Departments of Cardiology and Infectious Diseases, Sapienza University, Rome, Italy
| | - Claudio Mastroianni
- Departments of Cardiology and Infectious Diseases, Sapienza University, Rome, Italy
| | - Antonio Vitarelli
- Departments of Cardiology and Infectious Diseases, Sapienza University, Rome, Italy
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AlBackr H, Alhabib KF, Sulaiman K, Jamee A, Sobhy M, Benkhedda S, Dada S, Hammoudeh A, Gamra H, Al-Motarreb A, Alkindi F, Amin MI, Yousif MG, Farhan HA, Fellat N, Almahmeed W, Jarallah MA, Panduranga P, Abdelhamid M, Ghaly I, Djermane D, Chibane A, Skouri H, Jarrah M, Amor H, Alsagheer NK, Hozayen MA, Ahmed HS, Ali M, Ullah A, Saleh AA, Zannad F. Clinical Features, Socioeconomic Status, Management, and Outcomes of Acute Heart Failure: PEACE MENA Registry Phase I Results. Curr Vasc Pharmacol 2023; 21:257-267. [PMID: 37231723 DOI: 10.2174/1570161121666230525111259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/29/2023] [Accepted: 05/04/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION PEACE MENA (Program for the Evaluation and Management of Cardiac Events in the Middle East and North Africa) is a prospective registry in Arab countries for in-patients with acute myocardial infarction (AMI) or acute heart failure (AHF). Here, we report the baseline characteristics and outcomes of in-patients with AHF who were enrolled during the first 14 months of the recruitment phase. METHODS A prospective, multi-centre, multi-country study including patients hospitalized with AHF was conducted. Clinical characteristics, echocardiogram, BNP (B-type natriuretic peptide), socioeconomic status, management, 1-month, and 1-year outcomes are reported. RESULTS Between April 2019 and June 2020, a total of 1258 adults with AHF from 16 Arab countries were recruited. Their mean age was 63.3 (±15) years, 56.8% were men, 65% had monthly income ≤US$ 500, and 56% had limited education. Furthermore, 55% had diabetes mellitus, 67% had hypertension; 55% had HFrEF (heart failure with reduced ejection fraction), and 19% had HFpEF (heart failure with preserved ejection fraction). At 1 year, 3.6% had a heart failure-related device (0-22%) and 7.3% used an angiotensin receptor neprilysin inhibitor (0-43%). Mortality was 4.4% per 1 month and 11.77% per 1-year post-discharge. Compared with higher-income patients, lower-income patients had a higher 1-year total heart failure hospitalization rate (45.6 vs 29.9%, p=0.001), and the 1-year mortality difference was not statistically significant (13.2 vs 8.8%, p=0.059). CONCLUSION Most of the patients with AHF in Arab countries had a high burden of cardiac risk factors, low income, and low education status with great heterogeneity in key performance indicators of AHF management among Arab countries.
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Affiliation(s)
- Hanan AlBackr
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Khalid F Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | - Amal Jamee
- Nassar Medical Complex Hospital, Ministry of Health, Khan Younes, Gaza Strip, Palestine
| | - Mohamed Sobhy
- International Cardiac Center (ICC), Alexandria, Egypt
| | - Salim Benkhedda
- COCRG Laboratory, Cardiology Department, Mustapha Hospital, Benyoucef Benkhedda University, Algiers, Algeria
| | - Sobhi Dada
- Cardiology Department, Hammoud Hospital University Medical Centre, Saida, Lebanon
| | | | - Habib Gamra
- Research Laboratory LR 12SP16, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | | | - Fahad Alkindi
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Hasan A Farhan
- Iraqi Board for Medical Specializations, Baghdad Heart Center, Baghdad, Iraq
| | - Nadia Fellat
- Cardiology A department, Pole of Cardio Pneumology and Cardiothoracic Surgery, Ibn Sina University Hospital, Faculty of Medicine and Pharmacology of Rabat (FMPR), University Med V, Rabat, Morocco
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | | | | | - Magdy Abdelhamid
- Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
| | - Ihab Ghaly
- Alhyatt Heart and Vascular Center, Alexandria, Egypt
| | - Dahlia Djermane
- COCRG Laboratory, Cardiology Department, Mustapha Hospital, Benyoucef Benkhedda University, Algiers, Algeria
| | - Ahcene Chibane
- Internal Medicine and Cardiology Department, CHU Douéra, University Saad Dahlab, Blida, Algeria
| | - Hadi Skouri
- Cardiology Division - Internal Medicine Department at the American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohamad Jarrah
- Division of Cardiology, Internal Medicine Department, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan
| | - Hassen Amor
- Cardiology Department, Taher Sfar University Hospital, Mahdia, Tunisia
| | - Nora K Alsagheer
- Cardiology Department, Faculty of medicine, Sanaa University, Sanaa, Yemen
| | - Mohammed A Hozayen
- Cardiology Department, Arass General Hospital, Arass, Al Qaseem, Saudi Arabia
| | | | | | - Anhar Ullah
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Ayman Al Saleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Faiez Zannad
- Centre d'Investigation Clinique Inserm, Institut Lorrain du Coeur et des Vaisseaux, CHU, Université de Lorraine, Nancy, France
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Jan RK, Alsheikh-Ali A, Mulla AA, Sulaiman K, Panduranga P, Al-Mahmeed W, Bazargani N, Al-Suwaidi J, Al-Jarallah M, Al-Motarreb A, Salam A, Al-Zakwani I. Outcomes of guideline-based medical therapy in patients with acute heart failure and reduced left ventricular ejection fraction: Observations from the Gulf acute heart failure registry (Gulf CARE). Medicine (Baltimore) 2022; 101:e29452. [PMID: 35687781 PMCID: PMC9276384 DOI: 10.1097/md.0000000000029452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 04/22/2022] [Indexed: 01/04/2023] Open
Abstract
This study aimed to report on the use, predictors and outcomes of guideline-based medical therapy (GBMT) in patients with acute heart failure (HF) with reduced ejection fraction of <40% (HFrEF), from seven countries in the Arabian Gulf.Patients with acute HFrEF (N = 2680), aged 18 years or older, and hospitalized February-November 2012 were recruited and data were collected post discharge at 3 months (n = 2477) and 1 year (n = 2418). The use and doses of GBMT were evaluated as per European, American and Canadian HF guidelines. Analyses were performed using multivariate logistic regression. This study was registered at clinicaltrials.gov (NCT01467973).The majority of patients were on dual (39%) and triple (39%) GBMT modalities, 14% received one GBMT medication, while 7.2% were not on any GBMT medications. On admission, 80% of patients were on renin-angiotensin system (RAS) blockers, 75% on b-blockers and 56% on mineralocorticoid receptor antagonists (MRAs), with a small proportion of these patients were taking target doses (RAS blockers 13%, b-blockers 7.3%, MRAs 14%). Patients taking triple GBMT were younger (P < .001), less likely to have comorbidities such as diabetes mellitus (P < .001) and CKD/dialysis (P < .001), less likely to receive in-hospital invasive treatments (P < .001), and more likely to be treated by a cardiologist (P < .001), than patients on a single medication. Patients taking triple GBMT showed significantly reduced all-cause mortality both at 3-months (P = .048), and at 12-months (P = .003), compared to patients taking no GBMT.Triple GBMT prescribing and dosing in patients with HFrEF were suboptimal in the Arabian Gulf. Further studies are required to investigate GBMT utilization and dosing in the outpatient setting.
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Affiliation(s)
- Reem K. Jan
- College of Medicine, Mohammed Bin Rashid University of Medicine & Health Sciences, Dubai, UAE
| | - Alawi Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine & Health Sciences, Dubai, UAE
| | - Arif Al Mulla
- Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Kadhim Sulaiman
- Department of Cardiology, Royal Hospital, Muscat, Oman
- Director General of Specialized Medical Care, Ministry of Health, Muscat, Oman
| | | | - Wael Al-Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, UAE
| | | | - Jassim Al-Suwaidi
- Department of Adult Cardiology, Hamad Medical Corporation, Doha, Qatar
- Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Mohammed Al-Jarallah
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al-Amiri Hospital, Kuwait City, Kuwait
| | - Ahmed Al-Motarreb
- Department of Internal Medicine, Faculty of Medicine, Sana’a University, Sana’a, Yemen
| | - Amar Salam
- Department of Adult Cardiology, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, QU Health, Qatar University, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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Al-Motarreb A, AL-Suwaidi J. Khat Chewing and Cardiovascular Disease. Heart Views 2022; 23:103-107. [PMID: 36213431 PMCID: PMC9542965 DOI: 10.4103/heartviews.heartviews_88_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 06/07/2022] [Indexed: 11/04/2022] Open
Abstract
Khat chewing is a deeply rooted habit in Yemen. It has social, economic, and medical problems. Chronic use of khat chewing increases the risk of many medical complications. Cathinone, the main khat leaf constituent, has an indirect sympathomimetic action. The effect of khat chewing and cathinone on the cardiovascular system have been identified, including increased risk of hypertension and acute cardiovascular events, as well as increased risk of cardiovascular complications among patients presenting with Acute Coronary Syndrome who are khat chewers.
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Affiliation(s)
- Ahmed Al-Motarreb
- Cardiac Department, Faculty of Medicine, Sanaa University, Sana'a, Yemen,Address for correspondence: Prof. Ahmed Al-Motarreb, Professor of Cardiology, Cardiac Department, Faculty of Medicine, Sana’a University, Sana’a Yemen. E-mail:
| | - Jassim AL-Suwaidi
- Department of Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Agati L, Al-Kebsi M, Al-Motarreb A, Al-Wather N, Al-Tanobi A, Al-Fakih H, Al-Dahbali A. Characteristics and risk factors of yemeni patients presenting with myocardial infarction with nonobstructive coronary arteries (MINOCA). Heart Views 2021; 22:235-239. [PMID: 35330654 PMCID: PMC8939377 DOI: 10.4103/heartviews.heartviews_86_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 12/16/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Myocardial infarction with non-obstructive coronary artery (MINOCA) is a syndrome, which requires both clinical documentation of ST-elevation myocardial infarction (STEMI) (abnormal cardiac biomarker, ischemic symptoms, and electrocardiography changes) and detection of nonobstructive coronary arteries. The purpose of this study is to determine the incidence of and characteristics of patients with MINOCA in the Yemeni population. Methods: Consecutive patients admitted between January and June 2019 at Al-Thawra Hospital, Sana’a (Yemen), with STEMI diagnosis were enrolled in this study. Demographic, clinical, echocardiographic, and coronary angiography characteristics of patients were noted. Results MINOCA was identified in 63 patients (25%) out of 249 admitted with STEMI diagnosis at Al-Thawra Hospital. The mean age of MINOCA patients was similar to obstructive coronary group; however, they were more often females and less frequently with diabetes and family history of coronary artery disease. Other risk factors like smoking, arterial hypertension, dyslipidemia, and oral tobacco were similar. Conversely, the percentage of Khat chewers was significantly higher in the MINOCA patients (P < 0.01) as compared to obstructive group. Conclusions: The relatively high incidence of MINOCA in our country and the long list of multiple potential causes of MINOCA should open further working diagnosis after coronary angiography and further efforts for defining the cause of myocardial infarction in each individual patient in Middle East countries.
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Alhabib KF, Gamra H, Almahmeed W, Hammoudeh A, Benkheddah S, Al Jarallah M, Al-Motarreb A, Alquraishi M, Sobhy M, Yousif MG, Alkindi F, Fellat N, Amin MI, Ali M, Al Saleh A, Ullah A, Zannad F. Acute myocardial infarction and acute heart failure in the Middle East and North Africa: Study design and pilot phase study results from the PEACE MENA registry. PLoS One 2020; 15:e0236292. [PMID: 32697793 PMCID: PMC7375595 DOI: 10.1371/journal.pone.0236292] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/01/2020] [Indexed: 12/28/2022] Open
Abstract
Background This pilot study describes the overall design and results of the Program for the Evaluation and Management of the Cardiac Events registry for the Middle East and North Africa (MENA) Region. Methods This prospective, multi-center, multi-country study included patients hospitalized with acute myocardial infarction (AMI) and/or acute heart failure (AHF). We evaluated the clinical characteristics, socioeconomic and educational levels, management, in-hospital outcomes, and 30-day mortality rate of patients that were admitted to one tertiary-care center in each of 14 Arab countries in the MENA region. Results Between 22 April and 28 August 2018, 543 AMI and 381AHF patients were enrolled from 14 Arab countries (mean age, 57±12 years, 82.5% men). Over half of the patients in both study groups had low incomes with limited health care coverage, and limited education. Nearly half of the cohort had a history of diabetes mellitus, hypertension, or hypercholesterolemia. Among patients with ST-elevation myocardial infarctions, 56.4% received primary percutaneous interventions, 24% received thrombolysis, and 19.5% received no acute reperfusion therapy. The main causes of AHF were ischemic heart diseases (55%) and primary valvular heart diseases (15%). The in-hospital and 30-day mortality rates were 2.0% and 3.5%, respectively, for AMI, and 5.4% and 7.0%, respectively, for AHF. Conclusions This pilot study revealed a high prevalence of cardiovascular risk factors in patients with AMI and AHF in Arab countries, and low levels of socioeconomic and educational status. Future phases of the study will improve our understanding of the impact that these factors have on the management and outcomes of cardiac events in these patient populations.
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Affiliation(s)
- Khalid F. Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- * E-mail:
| | - Habib Gamra
- Research Laboratory LR 12SP16, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirate
| | | | - Salim Benkheddah
- Cardiology Department, Mustapha Hospital, University Benyoucef Benkhedda, Alger Ctre, Algeria
| | | | | | | | - Mohamed Sobhy
- International Cardiac Center (ICC), Alexandria, Egypt
| | | | - Fahad Alkindi
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Ayman Al Saleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Anhar Ullah
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Faiez Zannad
- Centre d'Investigation Clinique Inserm, Institut Lorrain du Coeur et des Vaisseaux, Université de Lorraine, CHU, Nancy, France
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10
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Al-Jarallah M, Rajan R, Al-Zakwani I, Dashti R, Bulbanat B, Ridha M, Sulaiman K, Alsheikh-Ali AA, Panduranga P, AlHabib KF, Al Suwaidi J, Al-Mahmeed W, AlFaleh H, Elasfar A, Al-Motarreb A, Bazargani N, Asaad N, Amin H. Mortality and Morbidity in HF rEF, HF mrEF, and HF pEF Patients with Diabetes in the Middle East. Oman Med J 2020; 35:e99. [PMID: 32095280 PMCID: PMC7026806 DOI: 10.5001/omj.2020.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 10/27/2019] [Indexed: 12/13/2022] Open
Abstract
Objectives We sought to estimate the mortality and morbidity in diabetic acute heart failure (AHF) patients stratified by left ventricular ejection fraction. Methods We analyzed the data of patients with AHF from seven Middle Eastern countries (Bahrain, Oman, Yemen, Kuwait, UAE, Qatar, and Saudi Arabia) from February to November 2012, who were enrolled in a multinational registry of patients with heart failure (HF). Results A total of 2258 AHF patients had diabetes mellitus. The mean age was 63.0±11.0 years (ranging from 18 to 99 years), and 60.3% (n = 1362) of the patients were males. The mean ejection fraction (EF) was 37.0±13.0%. HF with reduced EF (< 40%) (HFrEF) was observed in 1268 patients (56.2%), whereas 515 patients (22.8%) had mid-range (40-49%) (HFmrEF) and 475 patients (21.0%) had preserved EF (3 50%) (HFpEF). The overall cumulative all-cause mortalities at three- and 12-months follow-up were 11.8% (n = 266) and 20.7% (n = 467), respectively. Those with HFpEF were associated with lower three-months cumulative all-cause mortality compared to those with HFrEF (7.6% vs. 5.9%; adjusted odds ratio (aOR) = 0.54, 95% confidence interval (CI): 0.31-0.95; p = 0.031), but not significantly different when compared to those with HFmrEF (aOR = 0.86, 95% CI: 0.53-1.40; p = 0.554). There were largely no significant differences among the groups with regards to the 12-months all-cause cumulative mortality (11% vs. 11% vs. 10%; p = 0.984). There were also no significant differences in re-hospitalization rates between the three HF groups not only at three months (23% vs. 20% vs. 22%; p = 0.520), but at one-year follow-up (28% vs. 30% vs. 32%; p = 0.335). Conclusions Three-month cumulative all-cause mortality was high in diabetic HFrEF patients when compared to those with HFpEF. However, there were no significant differences in mortality at one-year follow-up between the HF groups. There were also no significant differences in re-hospitalization rates between the HF groups not only at three months but also at one-year follow-up in the Middle East.
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Affiliation(s)
- Mohammed Al-Jarallah
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al-Amiri Hospital, Kuwait City, Kuwait
| | - Rajesh Rajan
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al-Amiri Hospital, Kuwait City, Kuwait
| | - Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman and Gulf Health Research, Muscat, Oman
| | - Raja Dashti
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al-Amiri Hospital, Kuwait City, Kuwait
| | - Bassam Bulbanat
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al-Amiri Hospital, Kuwait City, Kuwait
| | - Mustafa Ridha
- Division of Cardiology, Al-Dabous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait
| | - Kadhim Sulaiman
- Department of Cardiology, Royal Hospital, and Director General of Specialized Medical Care, Ministry of Health, Muscat, Oman
| | - Alawi A Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | | | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Jassim Al Suwaidi
- Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Wael Al-Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, UAE
| | - Hussam AlFaleh
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Abdelfatah Elasfar
- Department of Adult Cardiology, King Salman Heart Centre, King Fahad Medical City, Riyadh, Saudi Arabia, and Cardiology Department, Tanta University, Tanta, Egypt
| | - Ahmed Al-Motarreb
- Department of Internal Medicine, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | | | - Nidal Asaad
- Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain
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11
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Ramirez III RL, Thomas CA, Anderson RJ, Bernardo RJ, Al-Motarreb A, Al-Suwaidi J, Zamanian RT, De Jesus Perez VA. Drug- and toxin-induced pulmonary arterial hypertension: Current state of the literature. Glob Cardiol Sci Pract 2020. [DOI: 10.21542/gcsp.2019.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Drug- and toxin-induced pulmonary arterial hypertension (PAH) is an increasingly important sub-group of group 1 pulmonary hypertension (PH). In the last 60 years, we have seen the rise and fall of numerous prescription and illicit agents that have caused severe and deadly outbreaks of PAH. Currently, drugs and toxins are classified into “possible” and “definite” risk factors for PAH. While the exact mechanisms and pathogenesis of drug- and toxin-induced PAH are currently unknown, novel clinical and basic science studies are beginning to unravel the biologic factors and genetic underpinnings responsible for disease development. The clinical management of affected patients can be challenging as it is often difficult to identify patients early and demonstrate causality between drugs and PAH. Given the recent trends in drug utilization and development, it is highly likely that we will continue to identify new agents capable of causing pulmonary vascular disease. We must keep a high index of suspicion in order to identify patients and new compounds deemed definite or likely risk factors for PAH. Practicing pharmacovigilance, raising awareness, and working in tandem with PH patient associations and drug regulatory agencies may ultimately be our most effective strategy in preventing the next deadly outbreak of drug- and toxin-induced PAH.
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12
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Abi Khalil C, Sulaiman K, Asaad N, AlHabib KF, Alsheikh-Ali A, Jameesh M, Al-Jarallah M, Bulbanat B, AlMahmeed W, Ridha M, Bazargani N, Amin H, Al-Motarreb A, AlFaleh H, Panduranga P, Mahfoud Z, Al Suwaidi J. Beta-Blockers and Cardiovascular Outcomes in Acute Heart Failure with a History of Coronary Artery Disease and an Ejection Fraction ≥ 40. Curr Vasc Pharmacol 2020; 18:644-651. [PMID: 31889498 DOI: 10.2174/1570161118666191231114203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 12/20/2022]
Abstract
The prognostic impact of beta-blockers (BB) in coronary artery disease (CAD) is controversial, especially in the post-reperfusion era. We studied in-hospital cardiovascular events in patients hospitalized for acute HF, a previous history of CAD and a left ventricular ejection fraction (LVEF) ≥40%, in relation to BB on admission; and 1-year outcome in relation to BB on discharge, in the GULF aCute heArt failuRe (GULF-CARE) registry. From a total of 5005 patients included in the GULF-CARE registry, 303 patients with a previous history of CAD and a LVEF ≥40% on BB were propensity-matched to 303 patients without BB on admission. In-hospital mortality (OR= 0.82; 95% CI [0.35-1.94]), stroke and cardiogenic shock were not reduced by BB. On discharge, 306 patients on BB, including the ones newly diagnosed with myocardial infarction as a precipitating cause of HF, were propensity-scored matched with 306 patients without BB. Mortality (OR= 0.86; 95%CI [0.51-1.45], hospitalization for HF or PCI/CABG at 1 year were also not reduced by BB at discharge. In summary, our data show that BB have a neutral effect on in-hospital and 1-year outcomes in acute heart failure patients with a previous history of CAD and a LVEF ≥40%.
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Affiliation(s)
| | | | - Nidal Asaad
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Alawi Alsheikh-Ali
- College of Medicine Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | | | - Bassam Bulbanat
- Department of Medicine, Al-Amiri Hospital, Kuwait City, Kuwait
| | - Wael AlMahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Mustafa Ridha
- Department of Cardiology, Adan Hospital, Kuwait City, Kuwait
| | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Bahrain
| | - Ahmed Al-Motarreb
- Department of Cardiology, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Husam AlFaleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | | | - Ziyad Mahfoud
- Biostatistics, Epidemiology and BioMathematical Research Core, Doha, Qatar
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13
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Salam AM, Sulaiman K, Alsheikh-Ali AA, Singh R, AlHabib KF, Al-Zakwani I, Asaad N, Al-Qahtani A, Al-Jarallah M, AlMahmeed W, Bulbanat B, Ridha M, Bazargani N, Amin H, Al-Motarreb A, Panduranga P, AlFaleh H, Shehab A, Al Suwaidi J. Precipitating Factors for Hospitalization with Heart Failure: Prevalence and Clinical Impact Observations from the Gulf CARE (Gulf aCute heArt failuRe rEgistry). Med Princ Pract 2020; 29:270-278. [PMID: 31522185 PMCID: PMC7315136 DOI: 10.1159/000503334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 09/15/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Despite the expanding burden of heart failure (HF) worldwide, data on HF precipitating factors (PFs) in developing countries, particularly the Middle East, are very limited. We examined PFs in patients hospitalized with acute HF in a prospective multicenter HF registry from 7 countries in the Middle East. METHOD Data were derived from the Gulf CARE (Gulf aCute heArt failuRe rEgistry) for a prospective, multinational, multicenter study of consecutive patients hospitalized with HF in 47 hospitals in 7 Middle Eastern countries between February 2012 and November 2012. PFs were determined by the treating physician from a predefined list at the time of hospitalization. RESULTS The study included 5,005 patients hospitalized with acute HF, 2,276 of whom (45.5%) were hospitalized with acute new-onset HF (NOHF) and 2,729 of whom (54.5%) had acute decompensated chronic HF (DCHF). PFs were identified in 4,319 patients (86.3%). The most common PF in the NOHF group was acute coronary syndromes (ACS) (39.2%). In the DCHF group, it was noncompliance with medications (27.8%). Overall, noncompliance with medications was associated with a lower inhospital mortality (OR 0.47; 95% CI 0.28-0.80; p = 0.005) but a higher 1-year mortality (OR 1.43; 95% CI 1.1-1.85; p = 0.007). ACS was associated with higher inhospital mortality (OR 1.84; 95% CI 1.26-2.68; p = 0.002) and higher 1-year mortality (OR 1.62; 95% CI 1.27-2.06; p = 0.001). CONCLUSION Preventive and therapeutic interventions specifically directed at noncompliance with medications and ACS are warranted in our region.
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Affiliation(s)
- Amar M Salam
- College of Medicine, Qatar University, Doha, Qatar,
- Adult Cardiology, Hamad Medical Corporation, Doha, Qatar,
| | | | - Alawi A Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Rajvir Singh
- Biostatistics Section, Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, and Gulf Health Research, Seeb, Oman
| | - Nidal Asaad
- College of Medicine, Qatar University, Doha, Qatar
| | | | | | | | - Bassam Bulbanat
- Department of Cardiology, Sabah Al-Ahmed Cardiac Center, Kuwait, Kuwait
| | - Mustafa Ridha
- Department of Cardiology, Adan Hospital, Kuwait, Kuwait
| | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Bahrain
| | - Ahmed Al-Motarreb
- Department of Cardiology, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | | | - Husam AlFaleh
- Department of Cardiology and Cardiovascular Surgery, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abdulla Shehab
- College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
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14
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Al-Jarallah M, Rajan R, Al-Zakwani I, Dashti R, Bulbanat B, Ridha M, Sulaiman K, Alsheikh-Ali AA, Panduranga P, AlHabib KF, Al Suwaidi J, Al-Mahmeed W, AlFaleh H, Elasfar A, Al-Motarreb A, Bazargani N, Asaad N, Amin H. Impact of diabetes on mortality and rehospitalization in acute heart failure patients stratified by ejection fraction. ESC Heart Fail 2019; 7:297-305. [PMID: 31825180 PMCID: PMC7083462 DOI: 10.1002/ehf2.12538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/19/2019] [Accepted: 09/17/2019] [Indexed: 12/28/2022] Open
Abstract
Aims The aim of this study is to determine the impact of diabetes mellitus on all‐cause mortality and rehospitalization rates at 3 months and at 1 year in patients admitted with acute heart failure (AHF) stratified by left ventricular ejection fraction (EF). Methods and results We analysed consecutive patients admitted to 47 hospitals in seven Middle Eastern countries (Saudi Arabia, Oman, Yemen, Kuwait, United Arab Emirates, Qatar, and Bahrain) with AHF from February to November 2012 with AHF who were enrolled in Gulf CARE, a multinational registry of patients with heart failure (HF). AHF patients were stratified into three groups: HF patients with reduced (EF) (HFrEF) (<40%), HF with mid‐range EF (HFmrEF) (40–49%), and HF patients with preserved EF (HFpEF) (≥50%). Analyses were performed using univariate and multivariate statistical techniques. The mean age of the cohort was 59 ± 15 years (ranging from 18 to 99 years), and 63% (n = 2887) of the patients were males. A total of 2258 (49%) AHF patients had diabetes mellitus. The mean EF was 37 ± 14%. A reduced EF was observed in 2683 patients (59%), whereas 962 patients (21%) had mid‐range and 932 patients (20%) had preserved EF. Multivariable analyses demonstrated no significant differences in all‐cause mortality between diabetics and non‐diabetics in all the three types of HF; at 3 months follow‐up: HFrEF [adjusted odds ratio (aOR), 1.30; 95% confidence interval (CI): 0.94–1.80; P = 0.119], HFmrEF (aOR, 0.98; 95% CI: 0.51–1.87; P = 0.952), and HFpEF (aOR, 0.69; 95% CI: 0.38–1.26; P = 0.225); and at 12‐months follow‐up: HFrEF (aOR, 1.25; 95% CI: 0.97–1.62; P = 0.080), HFmrEF (aOR, 1.07; 95% CI: 0.68–1.68; P = 0.783), and HFpEF (aOR, 1.07; 95% CI: 0.67–1.72; P = 0.779). There were also no significant differences in rehospitalization rates between diabetics and non‐diabetics in all the three types of HF; at 3 months follow‐up: HFrEF (aOR, 0.94; 95% CI: 0.74–1.19; P = 0.581), HFmrEF (aOR, 0.82; 95% CI: 0.53–1.26; P = 0.369), and HFpEF (aOR, 1.06; 95% CI: 0.64–1.78; P = 0.812); and at 12‐months follow‐up: HFrEF (aOR, 0.93; 95% CI: 0.73–1.17; P = 0.524), HFmrEF (aOR, 0.81; 95% CI: 0.56–1.17; P = 0.257), and HFpEF (aOR, 1.29; 95% CI: 0.82–2.05; P = 0.271). Conclusions There were no significant differences in 3 and 12 months all‐cause mortality as well as rehospitalization rates between diabetics and non‐diabetic patients in all the three types of AHF patients stratified by left ventricular ejection fraction.
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Affiliation(s)
- Mohammed Al-Jarallah
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, 13001, Kuwait
| | - Rajesh Rajan
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, 13001, Kuwait
| | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman & Gulf Health Research, Muscat, Oman
| | - Raja Dashti
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, 13001, Kuwait
| | - Bassam Bulbanat
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, 13001, Kuwait
| | - Mustafa Ridha
- Division of Cardiology, Al-Dabous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait
| | - Kadhim Sulaiman
- Department of Cardiology, Royal Hospital, Specialized Medical Care, Ministry of Health, Muscat, Oman
| | - Alawi A Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Jassim Al Suwaidi
- Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Wael Al-Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Hussam AlFaleh
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Abdelfatah Elasfar
- Department of Adult Cardiology, King Salman Heart Centre, King Fahad Medical City, Riyadh, Saudi Arabia.,Cardiology Department, Tanta University, Tanta, Egypt
| | - Ahmed Al-Motarreb
- Department of Internal Medicine, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Nidal Asaad
- Department of Adult Cardiology, Hamad Medical Corporation, Doha, Qatar
| | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain
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15
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Doi SA, Islam N, Sulaiman K, Alsheikh-Ali AA, Singh R, Al-Qahtani A, Asaad N, AlHabib KF, Al-Zakwani I, Al-Jarallah M, AlMahmeed W, Bulbanat B, Bazargani N, Amin H, Al-Motarreb A, AlFaleh H, Panduranga P, Shehab A, Al Suwaidi J, Salam AM. Demystifying Smoker's Paradox: A Propensity Score-Weighted Analysis in Patients Hospitalized With Acute Heart Failure. J Am Heart Assoc 2019; 8:e013056. [PMID: 31779564 PMCID: PMC6912958 DOI: 10.1161/jaha.119.013056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Smoker's paradox has been observed with several vascular disorders, yet there are limited data in patients with acute heart failure (HF). We examined the effects of smoking in patients with acute HF using data from a large multicenter registry. The objective was to determine if the design and analytic approach could explain the smoker's paradox in acute HF mortality. Methods and Results The data were sourced from the acute HF registry (Gulf CARE [Gulf Acute Heart Failure Registry]), a multicenter registry that recruited patients over 10 months admitted with a diagnosis of acute HF from 47 hospitals in 7 Middle Eastern countries. The association between smoking and mortality (in hospital) was examined using covariate adjustment, making use of mortality risk factors. A parallel analysis was performed using covariate balancing through propensity scores. Of 5005 patients hospitalized with acute HF, 1103 (22%) were current smokers. The in-hospital mortality rates were significantly lower in current smoker's before (odds ratio, 0.71; 95% CI, 0.52-0.96) and more so after (odds ratio, 0.47; 95% CI, 0.31-0.70) covariate adjustment. With the propensity score-derived covariate balance, the smoking effect became much less certain (odds ratio, 0.63; 95% CI, 0.36-1.11). Conclusions The current study illustrates the fact that the smoker's paradox is likely to be a result of residual confounding as covariate adjustment may not resolve this if there are many competing prognostic confounders. In this situation, propensity score methods for covariate balancing seem preferable. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01467973.
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Affiliation(s)
- Suhail A Doi
- College of Medicine QU Health Qatar University Doha Qatar
| | - Nazmul Islam
- College of Medicine QU Health Qatar University Doha Qatar
| | | | - Alawi A Alsheikh-Ali
- Mohammed Bin Rashid University of Medicine and Health Sciences Abu Dhabi United Arab Emirates
| | | | | | | | - Khalid F AlHabib
- Department of Cardiac Sciences King Fahad Cardiac Center King Saud University Riyadh Saudi Arabia
| | - Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy College of Medicine and Health Sciences Sultan Qaboos University Muscat Oman
| | | | - Wael AlMahmeed
- Sheikh Khalifa Medical City Abu Dhabi United Arab Emirates
| | - Bassam Bulbanat
- Department of Cardiology Sabah Al-Ahmed Cardiac Center ??? Kuwait
| | | | - Haitham Amin
- Department of Cardiology Mohammed Bin Khalifa Cardiac Center Manamah Bahrain
| | - Ahmed Al-Motarreb
- Department of Cardiology Faculty of Medicine Sana'a University Sana'a Yemen
| | - Husam AlFaleh
- Department of Cardiac Sciences King Fahad Cardiac Center King Saud University Riyadh Saudi Arabia
| | | | - Abdulla Shehab
- College of Medicine and Health Sciences UAE University ??? United Arab Emirates
| | - Jassim Al Suwaidi
- Hamad Medical Corporation Doha Qatar.,Weill Cornell Medical College Doha Qatar
| | - Amar M Salam
- College of Medicine QU Health Qatar University Doha Qatar.,Hamad Medical Corporation Doha Qatar.,Weill Cornell Medical College Doha Qatar
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16
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Rajan R, Al Jarallah M, Al Zakwani I, Dashti R, Bulbanat B, Ridha M, Sulaiman KF, Panduranga P, Almahmeed W, Al-Suwaidi J, Alsheikh-Ali A, AlHabib KF, Bazargani N, Asaad N, Al-Motarreb A, Amin H, AlFaleh H, Elasfar A. Impact of R-hf Risk Score on All-Cause Mortality in Acute Heart Failure Patients in the Middle East. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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El-Menyar A, Sulaiman K, Almahmeed W, Al-Motarreb A, Asaad N, AlHabib KF, Alsheikh-Ali AA, Al-Jarallah M, Singh R, Yacoub M, Al Suwaidi J. Shock Index in Patients Presenting With Acute Heart Failure: A Multicenter Multinational Observational Study. Angiology 2019; 70:938-946. [PMID: 31242749 DOI: 10.1177/0003319719857560] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Shock index (SI) has a prognostic role in coronary heart disease; however, data on acute heart failure (AHF) are lacking. We evaluated the predictive values of SI in patients with AHF. Data were retrospectively analyzed from the Gulf Acute Heart Failure Registry. Patients were categorized into low SI versus high SI based on the receiver operating characteristic curves. Primary outcomes included cardiogenic shock (CS) and mortality. Among 4818 patients with AHF, 1143 had an SI ≥0.9. Compared with SI <0.9, patients with high SI were more likely males, younger, and having advanced New York Heart Association class, fewer cardiovascular risk factors and less prehospital β-blockers and angiotensin-converting enzyme inhibitor use. Shock index had significant negative correlations with age, pulse pressure, mean arterial pressure, and left ventricle ejection fraction and had positive correlation with hospital length of stay. Shock index ≥0.9 was significantly associated with higher composite end points, in-hospital, and 3-month mortality. Shock index ≥0.9 had 96% negative predictive value (NPV) and 3.5 relative risk for mortality. Multivariate regression analysis showed that SI was independent predictor of mortality and CS. With a high NPV, SI is a simple reliable bedside tool for risk stratification of patients with AHF. However, this conclusion needs further support.
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Affiliation(s)
- Ayman El-Menyar
- 1 Clinical Medicine, Weill Cornel Medical College, Doha, Qatar.,2 Clinical Research, Hamad General Hospital, Doha, Qatar
| | | | - Wael Almahmeed
- 4 Heart & Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Ahmed Al-Motarreb
- 5 Department of Cardiology, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Nidal Asaad
- 6 Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khalid F AlHabib
- 7 Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alawi A Alsheikh-Ali
- 8 College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Rajvir Singh
- 6 Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Magdi Yacoub
- 10 Heart Science Centre, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Jassim Al Suwaidi
- 1 Clinical Medicine, Weill Cornel Medical College, Doha, Qatar.,6 Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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18
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El-Menyar AA, AlHabib K, Zubaid M, Alsheikh-Ali A, Sulaiman K, Almahmeed W, Amin H, Al-Motarreb A, Ullah A, Suwaidi JA. UTILITY OF SHOCK INDEX IN 24,636 PATIENTS PRESENTING WITH ACUTE CORONARY SYNDROME. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)30815-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Al-Zendani A, Al-Emad A, Al-Motarreb A, Amen M, Al-Sagheer N, Hadi HA, Al-Wather N, Al-Fakeh H, Cimino S, Agati L. Acute heart failure in Yemen. J Cardiovasc Med (Hagerstown) 2018; 20:156-158. [PMID: 30550524 DOI: 10.2459/jcm.0000000000000748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Aziz Al-Zendani
- Medicine Department, Faculty of Medicine and Health Sciences, Thamar University
| | - Adel Al-Emad
- Department of Community Medicine, Faculty of Medicine and Health Science
| | | | - Mervat Amen
- Cardiac Centre, AL-Thawrah Teaching Hospital, Sana'a, Yemen
| | - Nora Al-Sagheer
- Department of Medicine, Faculty of Medicine, Sana'a University
| | - Hana Abu Hadi
- Cardiac Centre, AL-Thawrah Teaching Hospital, Sana'a, Yemen
| | | | | | - Sara Cimino
- Department of Cardiology, 'Sapienza' University of Rome, Rome, Italy
| | - Luciano Agati
- Department of Cardiology, 'Sapienza' University of Rome, Rome, Italy
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20
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AL-Zendani A, Al-Emad A, Al-Motarreb A, Amen M, AL-Sagheer N, Hadi HA, Al-Wather N, AL-Fakeh H, Cimino S, Agati L. Acute heart failure in Yemen. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01244665-900000000-98410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Al-Jarallah M, Rajan R, Al-Zakwani I, Dashti R, Bulbanat B, Sulaiman K, Alsheikh-Ali AA, Panduranga P, AlHabib KF, Al Suwaidi J, Al-Mahmeed W, AlFaleh H, Elasfar A, Al-Motarreb A, Ridha M, Bazargani N, Asaad N, Amin H. Incidence and impact of cardiorenal anaemia syndrome on all-cause mortality in acute heart failure patients stratified by left ventricular ejection fraction in the Middle East. ESC Heart Fail 2018; 6:103-110. [PMID: 30315634 PMCID: PMC6352888 DOI: 10.1002/ehf2.12351] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/26/2018] [Indexed: 12/26/2022] Open
Abstract
AIMS This study aims to evaluate the incidence and impact of cardiorenal anaemia syndrome (CRAS) on all-cause mortality in acute heart failure (AHF) patients stratified by left ventricular ejection fraction (LVEF) status in the Middle East. METHODS AND RESULTS Data were analysed from 4934 consecutive patients admitted to 47 hospitals in seven Middle Eastern countries (Saudi Arabia, Oman, Yemen, Kuwait, United Arab Emirates, Qatar, and Bahrain) with AHF from February to November 2012. CRAS was defined as AHF with estimated glomerular filtration rate of <60 mL/min and low haemoglobin (<13 g/dL for men or <12 g/dL for women). Analyses were performed using univariate and multivariate statistical techniques. The overall mean age of the cohort was 59 ± 15 years, 62% (n = 3081) were men, and 27% (n = 1319) had CRAS. Co-morbid conditions were common including hypertension (n = 3014; 61%), coronary artery disease (n = 2971; 60%), and diabetes mellitus (n = 2449; 50%). A total of 79% (n = 3576) of the patients had AHF with reduced ejection fraction (HFrEF) (LVEF < 50%). CRAS patients were associated with major bleeding (1.29% vs. 0.6%; P = 0.017), blood transfusion (10.1% vs. 3.0%; P < 0.001), higher re-admission rate for AHF at 3 months' follow-up (27.6% vs. 18.8%; P < 0.001) and at 12 months' follow-up (34.3% vs. 26.2%; P < 0.001). Multivariate logistic regression demonstrated that patients with CRAS were associated with higher odds of all-cause mortality during hospital admission [adjusted odds ratio (aOR), 2.10; 95% confidence interval (CI): 1.34-3.31; P = 0.001], at 3 months' follow-up (aOR, 1.48; 95% CI: 1.07-2.06; P = 0.018), and at 12 months' follow-up (aOR, 1.45; 95% CI: 1.12-1.87; P = 0.004). Stratified analyses showed that CRAS patients with HFrEF were associated with higher odds of all-cause mortality during hospital admission (aOR, 2.03; 95% CI: 1.20-3.45; P = 0.009) and at 12 months' follow-up (aOR, 1.42; 95% CI: 1.06-1.89; P = 0.019) but not at 3 months' follow-up (aOR, 1.43; 95% CI: 0.98-2.09; P = 0.063). However, in AHF patients with preserved ejection fraction (LVEF ≥ 50%), CRAS was not associated with higher odds of all-cause mortality not only during hospital admission (aOR, 2.15; 95% CI: 0.84-5.55; P = 0.113) but also at 3 months' follow-up (aOR, 1.87; 95% CI: 0.93-3.76; P = 0.078) and at 12 months' follow-up (aOR, 1.59; 95% CI: 0.91-2.76; P = 0.101). CONCLUSIONS The incidence of CRAS was 27%. CRAS was associated with higher odds of all-cause mortality in AHF patients in the Middle East, especially in those with HFrEF.
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Affiliation(s)
| | - Rajesh Rajan
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait
| | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman.,Gulf Health Research, Muscat, Oman
| | - Raja Dashti
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait
| | - Bassam Bulbanat
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait
| | - Kadhim Sulaiman
- Department of Cardiology, Royal Hospital, Muscat, Oman.,Directorate General of Specialized Medical Care, Ministry of Health, Muscat, Oman
| | - Alawi A Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Jassim Al Suwaidi
- Department of Adult Cardiology, Hamad Medical Corporation, Doha, Qatar.,Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Wael Al-Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Hussam AlFaleh
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Abdelfatah Elasfar
- Department of Adult Cardiology, King Salman Heart Centre, King Fahad Medical City, Riyadh, Saudi Arabia.,Cardiology Department, Tanta University, Tanta, Egypt
| | - Ahmed Al-Motarreb
- Department of Internal Medicine, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Mustafa Ridha
- Division of Cardiology, Al-Dabbous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait
| | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Nidal Asaad
- Department of Adult Cardiology, Hamad Medical Corporation, Doha, Qatar
| | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain
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22
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Al-Zakwani I, Panduranga P, Al-Lawati JA, Sulaiman K, Alsheikh-Ali AA, AlHabib KF, Suwaidi JA, Al-Mahmeed W, AlFaleh H, Alnobani O, Al-Motarreb A, Ridha M, Bulbanat B, Al-Jarallah M, Bazargani N, Asaad N, Amin H. Impact of Clopidogrel on Mortality in Patients With Acute Heart Failure Stratified by Coronary Artery Disease: Findings From the Arabian Gulf Acute Heart Failure Registry (Gulf CARE). Angiology 2018; 69:884-891. [PMID: 29747514 DOI: 10.1177/0003319718775552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated the impact of clopidogrel use on 3- and 12-months all-cause mortality in patients with acute heart failure (AHF) stratified by coronary artery disease (CAD) in patients admitted to 47 hospitals in 7 Middle Eastern countries with AHF from February to November 2012. Clopidogrel use was associated with significantly lower risk of all-cause mortality at 3 months (adjusted odds ratio [aOR], 0.61; 95% confidence interval [CI]: 0.42-0.87; P = .007) and 12 months (aOR, 0.61; 95% CI: 0.47-0.79; P < .001). When the analysis was stratified by CAD, the clopidogrel group in those with AHF and CAD was also associated with significantly lower risk of all-cause mortality at 3 months (aOR, 0.56; 95% CI: 0.38-0.83; P = .003) and 12 months (aOR, 0.58; 95% CI: 0.44-0.77; P < .001). However, in AHF patients without CAD, clopidogrel use was not associated with any survival advantages, neither at 3 months (aOR, 0.99; 95% CI: 0.32-3.11; P = .987) nor at 12 months (aOR, 0.80; 95% CI: 0.37-1.72; P = .566). Clopidogrel use was associated with short- and long-term all-cause mortality in patients with AHF and CAD. In AHF patients without CAD, clopidogrel use did not offer any survival advantage.
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Affiliation(s)
- Ibrahim Al-Zakwani
- 1 Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University and Gulf Health Research, Muscat, Oman
| | | | | | - Kadhim Sulaiman
- 2 Department of Cardiology, Royal Hospital, Muscat, Oman.,3 Ministry of Health, Muscat, Oman
| | - Alawi A Alsheikh-Ali
- 4 College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Khalid F AlHabib
- 5 Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jassim Al Suwaidi
- 6 Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Wael Al-Mahmeed
- 7 Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Hussam AlFaleh
- 5 Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Omar Alnobani
- 5 Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Al-Motarreb
- 8 Department of Internal Medicine, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Mustafa Ridha
- 9 Division of Cardiology, Al-Dabous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait
| | - Bassam Bulbanat
- 10 Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait
| | | | - Nooshin Bazargani
- 11 Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Nidal Asaad
- 6 Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Haitham Amin
- 12 Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain
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23
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Salam AM, Sulaiman K, Alsheikh-Ali AA, Singh R, Asaad N, Al-Qahtani A, Salim I, AlHabib KF, Al-Zakwani I, Al-Jarallah M, AlMahmeed W, Bulbanat B, Ridha M, Bazargani N, Amin H, Al-Motarreb A, Al Faleh H, Albackr H, Panduranga P, Shehab A, Al Suwaidi J. Acute heart failure presentations and outcomes during the fasting month of Ramadan: an observational report from seven Middle Eastern countries. Curr Med Res Opin 2018; 34:237-245. [PMID: 28871820 DOI: 10.1080/03007995.2017.1376629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Fasting during the month of Ramadan is practiced by over 1.5 billion Muslims worldwide. It remains unclear, however, how this change in lifestyle affects heart failure, a condition that has reached epidemic dimensions. This study examined the effects of fasting in patients with acute heart failure (AHF) using data from a large multi-center heart failure registry. METHODS AND RESULTS Data were derived from Gulf CARE (Gulf aCute heArt failuRe rEgistry), a prospective multi-center study of consecutive patients hospitalized with AHF during February-November 2012. The study included 4,157 patients, of which 306 (7.4%) were hospitalized with AHF in the fasting month of Ramadan, while 3,851 patients (92.6%) were hospitalized in other days. Clinical characteristics, precipitating factors, management, and outcome were compared among the two groups. Patients admitted during Ramadan had significantly lower prevalence of symptoms and signs of volume overload compared to patients hospitalized in other months. Atrial arrhythmias were significantly less frequent and cholesterol levels were significantly lower in Ramadan. Hospitalization in Ramadan was not independently associated with increased immediate or 1-year mortality. CONCLUSIONS The current study represents the largest evaluation of the effects of fasting on AHF. It reports an improved volume status in fasting patients. There were also favorable effects on atrial arrhythmia and total cholesterol and no effects on immediate or long-term outcomes.
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Affiliation(s)
- Amar M Salam
- a Adult Cardiology , Hamad Medical Corporation , Doha , Qatar
| | | | - Alawi A Alsheikh-Ali
- c College of Medicine , Mohammed Bin Rashid University of Medicine and Health Sciences , Dubai , United Arab Emirates
- d Institute of Cardiac Sciences , Sheikh Khalifa Medical City , Abu Dhabi , United Arab Emirates
| | - Rajvir Singh
- e Biostatistics Section, Cardiovascular Research , Heart Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Nidal Asaad
- a Adult Cardiology , Hamad Medical Corporation , Doha , Qatar
| | - Awad Al-Qahtani
- a Adult Cardiology , Hamad Medical Corporation , Doha , Qatar
| | - Imtiaz Salim
- a Adult Cardiology , Hamad Medical Corporation , Doha , Qatar
| | - Khalid F AlHabib
- f Department of Cardiac Sciences , King Fahad Cardiac Center, King Saud University , Riyadh , Saudi Arabia
| | - Ibrahim Al-Zakwani
- g College of Medicine & Health Sciences, Department of Pharmacology & Clinical Pharmacy , Sultan Qaboos University, and Gulf Health Research , Oman
| | | | | | - Bassam Bulbanat
- h Department of Cardiology , Sabah Al-Ahmed Cardiac Center , Kuwait
| | | | - Nooshin Bazargani
- k Department of Cardiology , Dubai hospital , Dubai , United Arab Emirates
| | - Haitham Amin
- l Department of Cardiology , Mohammed Bin Khalifa Cardiac Center , Manamah , Bahrain
| | - Ahmed Al-Motarreb
- m Department of Cardiology, Faculty of Medicine , Sana'a University , Sana'a , Yemen
| | - Husam Al Faleh
- n Department of Cardiology and Cardiovascular Surgery , Security Forces Hospital , Riyadh , Saudi Arabia
| | - Hanan Albackr
- f Department of Cardiac Sciences , King Fahad Cardiac Center, King Saud University , Riyadh , Saudi Arabia
| | | | - Abdulla Shehab
- o Internal Medicine Department , College of Medicine and Health Sciences (CMHS), UAE University , United Arab Emirates
| | - Jassim Al Suwaidi
- a Adult Cardiology , Hamad Medical Corporation , Doha , Qatar
- p Qatar Cardiovascular Research Center , Doha , Qatar
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24
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Al-Zakwani I, Sulaiman K, Al-Lawati JA, Alsheikh-Ali AA, Panduranga P, Al-Habib KF, Al Suwaidi J, Al-Mahmeed W, Al-Faleh H, Elasfar A, Al-Motarreb A, Ridha M, Bulbanat B, Al-Jarallah M, Bazargani N, Asaad N, Amin H. Impact of Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptors Blockers on Mortality in Acute Heart Failure Patients with Left Ventricular Systolic Dysfunction in the Middle East: Observations from the Gulf Acute Heart Failure Registry (Gulf CARE). Curr Vasc Pharmacol 2017; 16:596-602. [PMID: 28820057 DOI: 10.2174/1570161115666170817164420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/19/2017] [Accepted: 07/24/2017] [Indexed: 11/22/2022]
Abstract
AIMS To evaluate the impact of Angiotensin-Converting Enzyme Inhibitors (ACEIs)/ Angiotensin Receptors Blockers (ARBs) on in-hospital, 3- and 12-month all-cause mortality in Acute Heart Failure (AHF) patients with left ventricular systolic dysfunction in 7 countries of the Middle East. METHODS AND RESULTS Data was analysed from 2,683 consecutive patients admitted with AHF and Left Ventricular Ejection Fraction (LVEF) (<40%) from 47 hospitals from February to November 2012. Analyses were evaluated using univariate and multivariate statistics. The overall mean age of the cohort was 58±15, 72% (n=1,937) were males, 62% (n=1,651) had coronary artery disease, 57% (n=1,539) were hypertensives and 47% (n=1,268) had diabetes. Overall cumulative mortality at inhospital, 3- and 12-month follow-up was 5.8% (n=155), 12.6% (n=338) and 20.4% (n=548), respectively. Adjusting for demographic and clinical characteristics as well as medication in a multivariate logistic regression model, ACEIs were associated with lower risk of in-hospital mortality (adjusted odds ratio (aOR), 0.48; 95% Confidence Interval (CI): 0.25 to 0.94; p=0.031). At 3-month follow-up, both ACEIs (aOR, 0.64; 95% CI: 0.43 to 0.95; p=0.025) and ARBs (aOR, 0.34; 95% CI: 0.18 to 0.62; p<0.001) were associated with lower risk of mortality. Additionally, at 12-month follow-up, those prescribed ACEIs (aOR, 0.71; 95% CI: 0.53 to 0.96; p=0.027) and ARBs (aOR, 0.47; 95% CI: 0.31 to 0.71; p<0.001) were still associated with lower risk of mortality. CONCLUSION ACEIs and ARBs treatments were associated with lower mortality risk during admission and up to 12-month of follow-up in Middle East AHF patients with left ventricular systolic dysfunction.
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Affiliation(s)
- Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University and Gulf Health Research, Muscat, Oman
| | - Kadhim Sulaiman
- Department of Cardiology, Royal Hospital, and Director General of Specialized Medical Care, Ministry of Health, Muscat, Oman
| | - Jawad A Al-Lawati
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Alawi A Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Khalid F Al-Habib
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Jassim Al Suwaidi
- Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Wael Al-Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Hussam Al-Faleh
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Abdelfatah Elasfar
- Department of Adult Cardiology, King Salman Heart Centre, King Fahad Medical City, Riyadh, Saudi Arabia, and Cardiology Department, Tanta University, Tanta, Egypt
| | - Ahmed Al-Motarreb
- Department of Internal Medicine, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Mustafa Ridha
- Division of Cardiology, Al-Dabous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait
| | - Bassam Bulbanat
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait
| | | | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Nidal Asaad
- Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain
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25
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Abi Khalil C, Sulaiman K, Mahfoud Z, Singh R, Asaad N, AlHabib KF, Alsheikh-Ali A, Al-Jarallah M, Bulbanat B, AlMahmeed W, Ridha M, Bazargani N, Amin H, Al-Motarreb A, Faleh HA, Elasfar A, Panduranga P, Suwaidi JA. Non-withdrawal of beta blockers in acute decompensated chronic and de novo heart failure with reduced ejection fraction in a prospective multicentre study of patients with acute heart failure in the Middle East. BMJ Open 2017; 7:e014915. [PMID: 28694343 PMCID: PMC5734353 DOI: 10.1136/bmjopen-2016-014915] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Beta blockers reduce mortality in heart failure (HF). However, it is not clear whether they should be temporarily withdrawn during acute HF. DESIGN Analysis of prospectively collected data. SETTING The Gulf aCute heArt failuRe rEgistry is a prospective multicentre study of patients hospitalised with acute HF in seven Middle Eastern countries. PARTICIPANTS 5005 patients with acute HF. OUTCOME MEASURES We studied the effect of beta blockers non-withdrawal on intrahospital, 3-month and 12-month mortality and rehospitalisation for HF in patients with acute decompensated chronic heart failure (ADCHF) and acute de novo heart failure (ADNHF) and a left ventricular ejection fraction (LVEF) <40%. RESULTS 44.1% of patients were already on beta blockers on inclusion. Among those, 57.8% had an LVEF <40%. Further, 79.9% were diagnosed with ADCHF and 20.4% with ADNHF. Mean age was 61 (SD 13.9) in the ADCHF group and 59.8 (SD 13.8) in the ADNHF group. Intrahospital mortality was lower in patients whose beta blocker therapy was not withdrawn in both the ADCHF and ADNHF groups. This protective effect persisted after multivariate analysis (OR 0.05, 95% CI 0.022 to 0.112; OR 0.018, 95% CI 0.003 to 0.122, respectively, p<0.001 for both) and propensity score matching even after correcting for variables that remained significant in the new model (OR 0.084, 95% CI 0.015 to 0.468, p=0.005; OR 0.047, 95% CI 0.013 to 0.169, p<0.001, respectively). At 3 months, mortality was still lower only in patients with ADCHF in whom beta blockers were maintained during initial hospitalisation. However, the benefit was lost after correcting for confounding factors. Interestingly, rehospitalisation for HF and length of hospital stay were unaffected by beta blockers discontinuation in all patients. CONCLUSION In summary, non-withdrawal of beta blockers in acute decompensated chronic and de novo heart failure with reduced ejection fraction is associated with lower intrahospital mortality but does not influence 3-month and 12-month mortality, rehospitalisation for heart failure,and the length of hospital stay. TRIAL REGISTRATION NUMBER NCT01467973; Post-results.
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Affiliation(s)
- Charbel Abi Khalil
- Department of Medicine, Weill Cornell Medicine, Doha, Qatar
- Department of Genetic Medicine, Weill Cornell Medicine, Doha, Qatar
- Adult Cardiology Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Ziyad Mahfoud
- Division of Global and Public Health, Weill Cornell Medicine, Doha, Qatar
| | - Rajvir Singh
- Adult Cardiology Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Nidal Asaad
- Adult Cardiology Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Alawi Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | | | | | - Wael AlMahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, UAE
| | - Mustafa Ridha
- Department of Cardiology, Adan Hospital, Kuwait, Kuwait
| | | | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Bahrain
| | - Ahmed Al-Motarreb
- Department of cardiology, Faculty of Medicine, Sana’a University, Sana, Yemen
| | - Husam Al Faleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Jassim Al Suwaidi
- Adult Cardiology Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Abi Khalil C, Sulaiman K, Singh R, Jayyousi A, Asaad N, AlHabib KF, Alsheikh-Ali A, Al-Jarallah M, Bulbanat B, AlMahmeed W, Dargham S, Ridha M, Bazargani N, Amin H, Al-Motarreb A, AlFaleh H, Elasfar A, Panduranga P, Al Suwaidi J. BMI is inversely correlated to the risk of mortality in patients with type 2 diabetes hospitalized for acute heart failure: Findings from the Gulf aCute heArt failuRE (Gulf-CARE) registry. Int J Cardiol 2017; 241:262-269. [PMID: 28291623 DOI: 10.1016/j.ijcard.2017.02.119] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND A U-shaped relationship has been reported between BMI and cardiovascular events among patients with acute heart failure (AHF). We hypothesized that an obesity paradox also governs the relationship between BMI and mortality in patients with type 2 diabetes (T2D) and AHF. METHODS We studied 3-month and 12-month mortality in patients with T2D hospitalized for AHF according to 5 BMI categories: Underweight (<20kg/m2), normal weight (referent group, 20-24.9kg/m2), overweight, (25-29.9kg/m2), obese (30-34.9kg/m2) and severely obese (≥35kg/m2), in the Gulf aCute heArt failuRe rEgistry (GULF-CARE). RESULTS Among the 5005 participants in this cohort, 2492 (49.8%) had T2D. Underweight patients had a higher 3-month and 12-month mortality risk (OR 2.04, 95% CI [1.02-4.08]; OR 2.44, 95% CI [1.35-4.3]; respectively), compared to normal weight. Severe obesity was associated with a lower 3-month and 12-month mortality risk (OR 0.53, 95% CI [0.34-0.83]; OR 0.58, 95% CI [0.42-0.81]; respectively). After adjustment for several risk variables in 2 different models, the primary outcome was still significantly increased in underweight patients, and decreased in severely obese patients, at 3months and 12months. Further, the odds of mortality decreases with increasing BMI by 0.38 at 3months and at 0.45 at 12months in a near-linear shape (p=0.007; p=0.037; respectively). CONCLUSIONS In this cohort of patients with AHF, BMI was inversely correlated to the risk of mortality in patients with T2D. Moreover, severe obesity was associated with less mortality risk.
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Affiliation(s)
- Charbel Abi Khalil
- Department of Medicine, Weill Cornell Medicine, Doha, Qatar; Department of Genetic Medicine, Weill Cornell Medicine, Doha, Qatar; Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
| | | | - Rajvir Singh
- Biostatistics Section, Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Amin Jayyousi
- Department of Endocrinology and Diabetes, Hamad Medical Corporation, Doha, Qatar
| | - Nidal Asaad
- Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Alawi Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Heath Sciences Dubai, United Arab Emirates
| | | | - Bassam Bulbanat
- Department of Medicine, Al-Amiri Hospital, Kuwait City, Kuwait
| | - Wael AlMahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, UAE
| | | | - Mustafa Ridha
- Department of Epidemiology and Global Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Bahrain
| | - Ahmed Al-Motarreb
- Department of Cardiology, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Husam AlFaleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Jassim Al Suwaidi
- Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Munibari AN, Al-Motarreb A, Al-Sagheer N, Hadi HA, Othman A, Al-Wather N, Hamoud A, Alawlagy M, Almehdar S, Alhammadi A, Almogayed M, Caretta G, Al Jabri A, Agati L. Clinical characteristics and outcomes of Yemeni patients with acute heart failure aged 50years or younger: Data from Gulf Acute Heart Failure Registry (Gulf CARE). Int J Cardiol 2017; 229:91-95. [DOI: 10.1016/j.ijcard.2016.11.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/07/2016] [Indexed: 10/20/2022]
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28
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Al Saleh AS, Alhabib KF, Alsheik-Ali AA, Sulaiman K, Alfaleh H, Alsaif S, Al Mahmeed W, Asaad N, Amin H, Al-Motarreb A, Al Suwaidi J, Hersi AS. Predictors and Impact of In-Hospital Recurrent Myocardial Infarction in Patients With Acute Coronary Syndrome: Findings From Gulf RACE-2. Angiology 2016; 68:508-512. [PMID: 27784731 DOI: 10.1177/0003319716674855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Little is known about the predictors and prognostic impact of recurrent in-hospital ischemia and infarction in patients with acute coronary syndrome (ACS). Our objectives were to determine the baseline characteristics, risk factors, and long-term outcomes of patients with recurrent myocardial infarction (Re-MI). METHODS We evaluated patients with ACS who were enrolled in the second Gulf Registry of Acute Coronary Events from October 2008 to June 2009. RESULTS Of 7925 patients with ACS, 167 (2.1%) developed in-hospital Re-MI. Patients with Re-MI were older (mean age: 58.7 ± 13.4 vs 56.8 ± 12.6; P = .045), had higher rates of hyperlipidemia (42.5% vs 32.6%; P = .019), and were more likely to present with ST-segment elevation myocardial infarction (STEMI; 74.25% vs 43.9%; P < .001) and Killip class 4 (8.4% vs 3.2%; P < .001) than patients without Re-MI. Patients with Re-MI were less likely to receive evidence-based therapies upon admission, including aspirin (94.6% vs 98.5%; P < .001), β-blockers (59.3% vs 74.7%; P < .001), and statins (86.8% vs 94.9%; P < .001), and were less frequently assessed with coronary angiography (29.3% vs 32.5%; P = .029). Predictors of recurrent events included history of angina, hypotension on presentation, admission diagnosis of STEMI, and decreased use of evidence-based therapies including aspirin, statins, and β-blockers upon admission. Patients with Re-MI had more in-hospital complications, including congestive heart failure (44.3% vs 12.4%) and cardiogenic shock (26.4% vs 5.3%), as well as higher mortality rates during hospitalization (23.4% vs 4.1%) and after a discharge period of 30 days (27% vs 7.8%) and 1 year (30.5% vs 11.7%; P < .001 for all comparisons). CONCLUSION In our study, patients with Re-MI were less likely to receive evidence-based therapies and had a worse prognosis in terms of in-hospital complications and higher mortality rates. High-risk patients should be monitored and managed differently to prevent secondary attacks.
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Affiliation(s)
- Abdullah S Al Saleh
- 1 Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid F Alhabib
- 1 Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alawi A Alsheik-Ali
- 2 Department of Cardiology, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | | | - Hussam Alfaleh
- 1 Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Shukri Alsaif
- 4 Department of Cardiology, Saud AlBabtain Cardiac Centre, Dammam, Saudi Arabia
| | - Wael Al Mahmeed
- 2 Department of Cardiology, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Nidal Asaad
- 5 Department of Cardiology and Cardiovascular Surgery, Hamad General Hospital, Doha, Qatar
| | - Haiham Amin
- 6 Department of Cardiology, Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain
| | | | - Jassim Al Suwaidi
- 5 Department of Cardiology and Cardiovascular Surgery, Hamad General Hospital, Doha, Qatar
| | - Ahmad S Hersi
- 1 Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Al-Lawati JA, Sulaiman KJ, Al-Zakwani I, Alsheikh-Ali AA, Panduranga P, Al-Habib KF, Al-Suwaidi J, Al-Mahmeed W, Al-Faleh H, El-Asfar A, Al-Motarreb A, Ridha M, Bulbanat B, Al-Jarallah M, Bazargani N, Asaad N, Amin H. Systolic Blood Pressure on Admission and Mortality in Patients Hospitalized With Acute Heart Failure: Observations From the Gulf Acute Heart Failure Registry. Angiology 2016; 68:584-591. [DOI: 10.1177/0003319716672525] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated the role of systolic blood pressure (SBP) in relation to in-hospital and postdischarge mortality in patients admitted with acute heart failure (AHF). The SBP of 4848 patients aged ≥18 years admitted with AHF was categorized into 5 groups: ≤90, 91 to 119, 120 to 139, 140 to 161, and >161 mm Hg. After adjusting for several confounders, multivariate logistic regression models showed that admission SBP was a significant predictor of mortality among both patients with preserved left ventricular function (defined as left ventricular ejection fraction [LVEF] ≥40%) and patients with left ventricular dysfunction (LVEF <40%). The adjusted odds ratios of in-hospital, 3-month, and 1-year mortality in the lowest SBP groups were 7.06 (95% confidence interval [CI]: 3.28-15.20; P < .001), 2.59 (95% CI: 1.35-4.96; P = .004), and 3.10 (95% CI: 2.04-4.72; P < .001) times the odds in the highest admission group (SBP > 161 mm Hg), respectively. We conclude that low admission SBP is an independent predictor of mortality in patients with AHF. The higher the admission SBP, the better the prognosis, regardless of age or LVEF.
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Affiliation(s)
- Jawad A. Al-Lawati
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Kadhim J. Sulaiman
- Department of Cardiology, Royal Hospital, Muscat, Oman
- Director General of Specialized Medical Care, Ministry of Health, Muscat, Oman
| | - Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University and Gulf Health Research, Muscat, Oman
| | - Alawi A. Alsheikh-Ali
- Department of Medicine, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Khalid F. Al-Habib
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Jassim Al-Suwaidi
- Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Wael Al-Mahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Hussam Al-Faleh
- Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia
| | - Abdelfatah El-Asfar
- Department of Adult Cardiology, King Salman Heart Centre, King Fahad Medical City, Riyadh, Saudi Arabia
- Department of Cardiology, Tanta University, Tanta, Egypt
| | - Ahmed Al-Motarreb
- Department of Internal Medicine, Faculty of Medicine, Sana’a University, Sana’a, Yemen
| | - Mustafa Ridha
- Division of Cardiology, Al-Dabbous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait
| | - Bassam Bulbanat
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait
| | | | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Nidal Asaad
- Department of Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Centre, Doha, Qatar
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Centre, Al-Manamah, Bahrain
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Khafaji HAR, Sulaiman K, Singh R, Alhabib KF, Asaad N, Alsheikh-Ali A, Al-Jarallah M, Bulbanat B, Almahmeed W, Ridha M, Bazargani N, Amin H, Al-Motarreb A, Faleh HA, Elasfar A, Panduranga P, Suwaidi JA. Chronic obstructive airway disease among patients hospitalized with acute heart failure; clinical characteristics, precipitating factors, management and outcome: Observational report from the Middle East. ACTA ACUST UNITED AC 2016; 17:55-66. [DOI: 10.1080/17482941.2016.1203438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Hadi A. R. Khafaji
- Department of Cardiology, Saint Michael's Hospital, Toronto University, Toronto, Canada
| | - Kadhim Sulaiman
- Biostatistics Section, Department of Cardiology, Royal Hospital, Muscat, Oman
| | - Rajvir Singh
- Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khalid F. Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Nidal Asaad
- Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Alawi Alsheikh-Ali
- Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | | | - Bassam Bulbanat
- Department of Cardiology, Sabah Al-Ahmed Cardiac Center, Kuwait City, Kuwait
| | - Wael Almahmeed
- Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mustafa Ridha
- Department of Cardiology, Adan Hospital, Hadiya, Kuwait
| | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Bahrain
| | - Ahmed Al-Motarreb
- Department of Cardiology, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Husam Al Faleh
- Department of Cardiology and Cardiovascular Surgery, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abdelfatah Elasfar
- Department of Cardiology, Prince Salman Heart Center, King Fahad Medical City, Saudi Arabia
| | | | - Jassim Al Suwaidi
- Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
- Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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31
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Thalib L, Furuya-Kanamori L, AlHabib KF, Alfaleh HF, AlShamiri MQ, Amin H, Al Suwaidi J, Sulaiman K, Almahmeed W, Alsheikh-Ali AA, Al-Motarreb A, Doi SAR. Validation of the 6-Month GRACE Score in Predicting 1-Year Mortality of Patients With Acute Coronary Syndrome Admitted to the Arabian Gulf Hospitals. Angiology 2016; 68:251-256. [PMID: 27432444 DOI: 10.1177/0003319716659179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Acute coronary syndromes (ACS) are the most common cardiovascular diseases and are associated with a significant risk of mortality and morbidity. The Global Registry of Acute Coronary Events (GRACE) risk score postdischarge is a widely used ACS prediction model for risk of mortality (low, intermediate, and high); however, it has not yet been validated in patients from the Arabian Gulf. This prospective multicenter study (second Gulf Registry of Acute Coronary Events) provides detailed information of the GRACE risk score postdischarge in patients from the Arabian Gulf. Its prognostic utility was validated at 1-year follow-up in over 5000 patients with ACS from 65 hospitals in 6 Arabian Gulf countries (Bahrain, Saudi Arabia, Qatar, Oman, United Arab Emirates, and Yemen). Overall, the goodness of fit (Hosmer and Lemeshow statistic P value = .826), calibration, and discrimination (area under the receiver operating characteristic curve = 0.695; 95% confidence interval: 0.668-0.722) were good. The GRACE risk score postdischarge can be used to stratify 1 year mortality risk in the Arabian Gulf population; it does not require further calibration and has a good discriminatory ability.
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Affiliation(s)
- Lukman Thalib
- 1 Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
| | - Luis Furuya-Kanamori
- 2 Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Khalid F AlHabib
- 3 Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hussam F Alfaleh
- 3 Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mostafa Q AlShamiri
- 3 Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Haitham Amin
- 4 Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain
| | | | | | - Wael Almahmeed
- 7 Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Alawi A Alsheikh-Ali
- 8 College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,9 Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.,10 Institute for Clinical Research and Health Policy Studies, Tufts University School of Medicine, Boston, MA, USA
| | | | - Suhail A R Doi
- 2 Research School of Population Health, Australian National University, Canberra, ACT, Australia.,12 College of Medicine, Qatar University, Doha, Qatar.,13 School of Agricultural, Environmental and Computing Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia
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Panduranga P, Al-Zakwani I, Sulaiman K, Al-Habib K, Alsheikh-Ali A, Al-Suwaidi J, Al-Mahmeed W, Al-Faleh H, Elasfar A, Ridha M, Bulbanat B, Al-Jarallah M, Asaad N, Bazargani N, Al-Motarreb A, Amin H. Comparison of Indian subcontinent and Middle East acute heart failure patients: Results from the Gulf Acute Heart Failure Registry. Indian Heart J 2015; 68 Suppl 1:S36-44. [PMID: 27056651 PMCID: PMC4824330 DOI: 10.1016/j.ihj.2015.11.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 11/05/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To compare Middle East Arabs and Indian subcontinent acute heart failure (AHF) patients. METHODS AHF patients admitted from February 14, 2012 to November 14, 2012 in 47 hospitals among 7 Middle East countries. RESULTS The Middle Eastern Arab group (4157) was older (60 vs. 54 years), with high prevalence of coronary artery disease (48% vs. 37%), valvular heart disease (14% vs. 7%), atrial fibrillation (12% vs. 7%), and khat chewing (21% vs. 1%). Indian subcontinent patients (382) were more likely to be smokers (36% vs. 21%), alcohol consumers (11% vs. 2%), diabetic (56% vs. 49%) with high prevalence of AHF with reduced ejection fraction (76% vs. 65%), and with acute coronary syndrome (46% vs. 26%). In-hospital mortality was 6.5% with no difference, but 3-month and 12-month mortalities were significantly high among Middle East Arabs, (13.7% vs. 7.6%) and (22.8% vs. 17.1%), respectively. CONCLUSIONS AHF patients from this region are a decade younger than Western patients with high prevalence of ischemic heart disease, diabetes mellitus, and AHF with reduced ejection fraction. There is an urgent need to control risk factors among both groups, as well as the need for setting up heart failure clinics for better postdischarge management.
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Affiliation(s)
| | - Ibrahim Al-Zakwani
- Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Oman
| | | | - Khalid Al-Habib
- Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Alawi Alsheikh-Ali
- Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Jassim Al-Suwaidi
- Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Center, Doha, Qatar
| | - Wael Al-Mahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Hussam Al-Faleh
- Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Abdelfatah Elasfar
- Adult Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia; Tanta University, Egypt
| | | | | | | | - Nidal Asaad
- Adult Cardiology, Hamad Medical Corporation and Qatar Cardiovascular Research Center, Doha, Qatar
| | | | - Ahmed Al-Motarreb
- Internal Medicine, Faculty of Medicine, Sana'a University, Sana'a, Yemen
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AlFaleh HF, Alsheikh-Ali AA, Ullah A, AlHabib KF, Hersi A, Suwaidi JA, Sulaiman K, Saif SA, Almahmeed W, Asaad N, Amin H, Al-Motarreb A, Kashour T. Validation of the Canada Acute Coronary Syndrome Risk Score for Hospital Mortality in the Gulf Registry of Acute Coronary Events-2. Clin Cardiol 2015; 38:542-7. [PMID: 26418408 DOI: 10.1002/clc.22446] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 07/24/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Several risk scores have been developed for acute coronary syndrome (ACS) patients, but their use is limited by their complexity. The new Canada Acute Coronary Syndrome (C-ACS) risk score is a simple risk-assessment tool for ACS patients. This study assessed the performance of the C-ACS risk score in predicting hospital mortality in a contemporary Middle Eastern ACS cohort. HYPOTHESIS The C-ACS score accurately predicts hospital mortality in ACS patients. METHODS The baseline risk of 7929 patients from 6 Arab countries who were enrolled in the Gulf RACE-2 registry was assessed using the C-ACS risk score. The score ranged from 0 to 4, with 1 point assigned for the presence of each of the following variables: age ≥75 years, Killip class >1, systolic blood pressure <100 mm Hg, and heart rate >100 bpm. The discriminative ability and calibration of the score were assessed using C statistics and goodness-of-fit tests, respectively. RESULTS The C-ACS score demonstrated good predictive values for hospital mortality in all ACS patients with a C statistic of 0.77 (95% confidence interval [CI]: 0.74-0.80) and in ST-segment elevation myocardial infarction and non-ST-segment elevation acute coronary syndrome patients (C statistic: 0.76, 95% CI: 0.73-0.79; and C statistic: 0.80, 95% CI: 0.75-0.84, respectively). The discriminative ability of the score was moderate regardless of age category, nationality, and diabetic status. Overall, calibration was optimal in all subgroups. CONCLUSIONS The new C-ACS score performed well in predicting hospital mortality in a contemporary ACS population outside North America.
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Affiliation(s)
- Hussam F AlFaleh
- Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Alawi A Alsheikh-Ali
- College of Medicine, Mohammed bin Rashid University of Medicine and health sciences, Dubai, United Arab Emirates
| | - Anhar Ullah
- Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ahmad Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | | | - Shukri Al Saif
- Cardiology Department, Saud Al Babtain Cardiac Center, Dammam, Saudi Arabia
| | - Wael Almahmeed
- Department of Cardiology, Heart and vascular institute Cleveland clinic Abu Dhabi, United Arab Emirates
| | - Nidal Asaad
- Department of Cardiology, Hamad Medical Corporation, Doha, Qatar
| | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain
| | | | - Tarek Kashour
- Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Rahman MT, Helmy M, Ismail M, Helmy S, Husain A, Selimovic N, Husain A, Alsaddah J, Khaliel F, Al-Kumaim M, Jamali QA, Jaafar A, Shareef MA, Alsaddah J, Bitar ZI, Abdelaal KM, Khaliel F, Elameen SM, Al-Zakwani I, Gaber R, Gaber R, Gafarov VV, Gafarov V, Kassem HH, Kassem HH, Ali DMS, Alfaddagh A, Alhalabi B, Aman K, Rashed W, Al-Awadi A, Al-Awadhi N, Al-Kumim M, Zubaid R, Zubaid R, Ahmed A, Usha PT, Kassem HH, Al-Youha D, Ahmed A, Ahmed A, Alsayegh Z, Hussein G, Ahmed A, Rashed W, Salem DM, Al-huthaifi A, Mohammad BI, Mohamed GA, Hamdy S, Mohamed GA, Aboushokka W, AL-Khawlani N, AlSadda J, Majumder AAS, Rahman A, Ali M, Chowdhury AW, Abdelal K, Ibrahem M, Nassar M, Hamad M, Arafa S, Elyas A, Anilkumar S, Alzaeem H, Hajar R, AlBannay R, Agrwal S, AlHaiky W, Makki K, Koshy S, Mahdi N, AlAlawi S, AlAlawi M, Haidr M, Alburaiki J, Khaliel F, Alsanei A, Eyjolfsson A, Kjellamn U, Saad E, Halees Z, AlSanei A, Halees Z, Selimovic N, Alkandari S, Almutairi M, Shokka WA, Anwer LA, Selimovic N, Kjellman U, AlSanei A, Alanazi M, Saad E, Alburaiki J, AlHalees Z, Al-Khateeb A, Al-Motarreb A, Al-Shami M, Munibari A, Al-Qudaimi A, Minshall I, Abdulwahab M, Al-Hashemi E, Rahmatullah SH, Selimovic N, AlShahid M, AlHalees Z, Khaliel F, Alkandari S, Almutairi M, Maadarani O, Almerri K, Abdelghafaar AM, mosalam K, Anwer LA, Abudan A, Aqil SM, AlHalees Z, AlSanei A, Khan S, Selimovic N, Othman MA, Katta A, Usama M, Panduranga P, Zubaid M, Sulaiman K, Rashed W, Alsheikh-Ali A, AlMahmeed W, Shehab A, Al Qudaimi A, Asaad N, Amin H, Bayomy S, Atalla W, Panov DO, Gromova EA, Gagulin IV, Gafarova AV, Panov D, Gromova E, Gagulin I, Gafarova A, Abdullah A, Al-Jarallah M, Sayed W, Aljarallah MA, El Shafy DSKA, Allah DEA, Bakri DMH, Mohamed HA, Ghoneim DA, Alhalabi B, Al-Nassar A, Zaher R, Al-Awadhi N, Longnecker JC, Alfaddagh A, Zaher R, Al-Awadhi N, Al-Nassar A, Longenecker J, Saeed A, Kassim S, Zubaid M, Alsheikh-Ali A, Alrawahi N, Ridha M, Akbar M, Alenezi F, Alhamdan R, Almahmeed W, Ouda H, Al-Mulla A, Baslaib F, Shehab A, Alnuaimi A, Amin H, Krumholz HM, Al-Sabt Y, Al-Shammari A, Dawod M, Al-Janfawi M, Zaher R, Al-Nassar A, Alhalabi B, Alfaddagh A, Longenecker J, Al-Sagheer N, Munibari AN, Ridha M, Akbar M, Ridha M, Akbar M, Jamiel A, Al-Mallah MH, Rajesh R, Faybushevich AG, Hemeda AA, Mousa AT, Aljarallah MA, Al-Nami N, El-Ghandour N, Al-Fahad F, Mohammed A, Al-Huwais S, Al-Taiar A, Al-Mallah MH, Al-Mallah MH, Mutairi M, Mistry B, Alsayegh A, Mostafa FA, Zekri H, Elmahdy S, Khalid F, Qureshi W, AL-Mallah MH, Zubaid M, Alsheikh-Ali A, Alrawahi N, Ridha M, Akbar M, Alenezi F, Alhamdan R, Almahmeed W, Ouda H, Al-Mulla A, Baslaib F, Shehab A, Alnuaimi A, Amin H, Krumholz HM, Bashawar DZ, Alali DA, Namazi MH, Vakili H, Safi M, Saadat H, Yousif FG, Yousif MS, Gaber MA, Abd-Elazeem A, Mohamed GA, Mustafa S, Wahed LA, El-Deen HS, Zedan M, Abd-Elrahman MZ, Soliman H, Mahran R, ElKady T, AL-Khawlani A, AL-Motarreb A, Sherif S, AlMilahi M, AlMutairi M, Hayat N. Gulf Heart Assocation 2015 Conference Proceedings Abstracts14Immediate and In-hospital Complications of Percutaneous Coronary Intervention22Mitral Valve Replacement in the Presence of Severe Pulmonary Hypertension in Upper Egypt33Anomalous Left Anterior Descending Coronary Artery Arising from Pulmonary Artery in a 63 year-old patient Case Report34Accuracy of global longitudinal strain analysis in early diagnosis and localization of significant coronary artery lesions in non st - elevation acute coronary syndrome37Heart rate at discharge is an independent predictor of readmission and mortality among patients admitted with acute heart failure. Cohort analysis from Salmaniya Medical Complex - Kingdom of Bahrain38More than 200 heart transplantation from the single centre in the Middle East. All time high: 22 heart transplantation during the first 10 months at King Faisal Specialist Hospital and Research Centre, Riyadh39Outcomes of patients with reduced left ventricular systolic function undergoing heart surgery at King Faisal Hospital & Research Center40Pattern of in-hospital Cardiac Catheterization for Patients with Acute Coronary Syndrome in Kuwait42Incidence of Malignancies among Post Heart Transplant Patients in the Middle East; is it of Any Significance to the Rest of the World?52Percutaneous Mitral Balloon Valvuloplasty in Yemeni Patients; The challenges Never Ends53Importance of Health Education in improving the Quality of life of people with Chronic Diseases55Influence of Rescuers' Gender and Body Mass Index on Cardiopulmonary Resuscitation According to the American Heart Association 2010 Resuscitation Guidelines56Postoperative Mid-Term Results of Tricuspid Valve Surgery: Does Valve Repair Have a Better Outcome?58Clinical and Angiographic gender differences in patients undergoing Coronary Angiography61Sonographic chest B-lines with echocardiography Probe anticipate Elevated N-terminal pro-brain-type natriuretic peptide, irrespective of ejection fraction62Regain Interest in Semi-continuous Sutures in Prosthetic Valve Replacement65Accuracy of Predictive Operative Mortality Models in Octogenarians; a 10-Year Follow-Up Post Open Heart Surgery66What is the optimum management of Pacemaker Lead Endocarditis with multiple vegetations?67Should digoxin be prescribed in atrial fibrillation patients with or without heart failure? Results from Gulf Survey of Atrial Fibrillation Events (Gulf SAFE) in the Middle East69Detection of Early Left Ventricular Systolic and Diastolic Dysfunction in Patients with Maternoplacental Syndrome byTissue Doppler and Strain Rate Imaging70Right Ventricular Function Assessment in Single LAD lesion Patients Using Strain and Strain Rate Imaging74Anxiety traits and long-term risk of myocardial infarction and stroke in female population 25–64 years in Russia: MONICA-Psychosocial Epidemiological Study75The effect of personal anxiety on 16 years risk of an arterial hypertension in female population aged 25–64 in Russia: based on WHO epidemiological program MONICA-psychosocial77Comparison between Kuwaitis and expatriates in clinical features and outcome of primary PCI for acute ST elevation MI78Gender-related differences in the presentation, performance and outcome of primary PCI in a tertiary center in Kuwait79Venous saturations from central venous line and from venous side of heart lung machine are not interchangeable with mixed venous saturation from the pulmonary artery in children undergoing open heart surgery83Practice of smoking cessation counselling among physicians in Kuwait84Patterns of tobacco smoking among physicians in Kuwait85Cardiac Status among End Stage Renal Disease Patients on Maintenance Haemodialysis in Aden, Yemen: A Cross Sectional Study92Management and outcomes of Gulf citizens with ST elevation myocardial infarction: Findings from Gulf COAST99The Effect of Acute Epicatechin-3-gallate, Epigallocatechin and Epigallocatechin-3 Gallate Treatment on Tobacco Smoking Induced Heart Failure, In Ischemia/Reperfusion Rat Heart Model103Smoking patterns and smoking cessation counseling practices among medical students in Kuwait104Early Experience in Percutaneous Coronary Intervention for complex Lesion among Yemeni Patients106Influence of gender on presentation and outcomes of atrial fibrillation in Kuwait107Characteristics and outcomes of patients with atrial fibrillation in Kuwait108Prognostic Value of Normal Dobutamine Stress Echocardiography in Patients with Acute Chest Pain: A 15-years Follow up Study109Mitral Stenosis– Impact of Deranged Pulmonary Function Tests on Early Postoperative Outcome111Analysis of in-hospital delay components in patients with STEMI going for primary PCI in a single center112Association between Oral Hygiene Practices and Coronary Heart Disease in Kuwait113Under-utilization of Nuclear Myocardial Perfusion Imaging in the Middle East114Temporal Trends of Cardiorespiratory Fitness in Saudi Arabia: A Call for Action117Radiofrequency catheter ablation of atrial tachycardia using 3D mapping with the EnSite system118Exercise Intolerance in Postoperative Fallot Repair, Does it Correlate with Pulmonary Regurgitation?119Incremental Prognostic Value of Myocardial Perfusion Imaging in Patients with Renal Dysfunction120Impact of bleeding in patients with acute coronary syndrome on morbidity and mortality in the Gulf Region121Improving Documentation of Cardio-Vascular Disease Risk in Medical Records of Diabetic Patients attending Non Communicable Disease Clinics at West Bay Health Center in Qatar124The non-hyperemic coronary pressure notch as an indicator of the physiologic significance of coronary artery stenosis125Cardioprotective Effect Of Selenium And N-Acetylcysteine Versus Their Combination Against Myocardial Ischemia–Reperfusion Injury126Association between albuminuria and abnormal cardiac Findings in patients with type 2 diabetic nephropathy: Role of Urine Albumin Excretion129Sub-clinical cardiovascular changes in chronic obstructive pulmonary disease patients: Doppler ultrasound evaluation130Interleukin-6 and C-reactive protein as a marker of severity in Adult with diabetic ketoacidosis131Carotid artery stenting in asymptomatic tight carotid artery stenosis scheduled for elective CABG surgery. (CASCADE study)132Prevalence of metabolic syndrome in patients with acute coronary syndrome in Yemen Data from Gulf Race133Catheterization in Post CABG (Coronary Artery Bypass Graft); Lessons Learned. Eur Heart J Suppl 2015. [DOI: 10.1093/eurheartj/suv043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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El-Menyar A, Mekkodathil A, Al-Thani H, Al-Motarreb A. Khat use: history and heart failure. Oman Med J 2015; 30:77-82. [PMID: 25960830 DOI: 10.5001/omj.2015.18] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 02/01/2015] [Indexed: 12/15/2022] Open
Abstract
Recent reports suggest that 20 million people worldwide are regularly using khat as a stimulant, even though the habit of chewing khat is known to cause serious health issues. Historical evidence suggests khat use has existed since the 13th century in Ethiopia and the southwestern Arabian regions even before the cultivation and use of coffee. In the past three decades, its availability and use spread all over the world including the United States and Europe. Most of the consumers in the Western world are immigrant groups from Eastern Africa or the Middle East. The global transport and availability of khat has been enhanced by the development of synthetic forms of its active component. The World Health Organization considers khat a drug of abuse since it causes a range of health problems. However, it remains lawful in some countries. Khat use has long been a part of Yemeni culture and is used in virtually every social occasion. The main component of khat is cathinone, which is structurally and functionally similar to amphetamine and cocaine. Several studies have demonstrated that khat chewing has unfavorable cardiovascular effects. The effect on the myocardium could be explained by its effect on the heart rate, blood pressure, its vasomotor effect on the coronary vessels, and its amphetamine-like effects. However, its direct effect on the myocardium needs further elaboration. To date, there are few articles that contribute death among khat chewers to khat-induced heart failure. Further studies are needed to address the risk factors in khat chewers that may explain khat-induced cardiotoxicity, cardiomyopathy, and heart failure.
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Affiliation(s)
- Ayman El-Menyar
- Clinical Medicine, Weill Cornell Medical College, Doha, Qatar ; Cardiology Unit, Ahmed Maher Teaching Hospital, Egypt ; Clinical Research, Hamad Medical Corporation, Doha, Qatar
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Khafaji HAR, Sulaiman K, Singh R, AlHabib KF, Asaad N, Alsheikh-Ali A, Al-Jarallah M, Bulbanat B, AlMahmeed W, Ridha M, Bazargani N, Amin H, Al-Motarreb A, AlFaleh H, Elasfar A, Panduranga P, Al Suwaidi J. Clinical characteristics, precipitating factors, management and outcome of patients with prior stroke hospitalised with heart failure: an observational report from the Middle East. BMJ Open 2015; 5:e007148. [PMID: 25908674 PMCID: PMC4410120 DOI: 10.1136/bmjopen-2014-007148] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/20/2015] [Accepted: 03/01/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The purpose of this study is to report the prevalence, clinical characteristics, precipitating factors, management and outcome of patients with prior stroke hospitalised with acute heart failure (HF). DESIGN Retrospective analysis of prospectively collected data. SETTING Data were derived from Gulf CARE (Gulf aCute heArt failuRe rEgistry), a prospective multicentre study of consecutive patients hospitalised with acute HF in 2012 in seven Middle Eastern countries and analysed according to the presence or absence of prior stroke; demographics, management and outcomes were compared. PARTICIPANTS A total of 5005 patients with HF. OUTCOME MEASURES In-hospital and 1-year outcome. RESULTS The prevalence of prior stroke in patients with HF was 8.1%. Patients with stroke with HF were more likely to be admitted under the care of internists rather than cardiologists. When compared with patients without stroke, patients with stroke were more likely to be older and to have diabetes mellitus, hypertension, atrial fibrillation, hyperlipidaemia, chronic kidney disease, ischaemic heart disease, peripheral arterial disease and left ventricular dysfunction (p=0.001 for all). Patients with stroke were less likely to be smokers (0.003). There were no significant differences in terms of precipitating risk factors for HF hospitalisation between the two groups. Patients with stroke with HF had a longer hospital stay (mean±SD days; 11±14 vs 9±13, p=0.03), higher risk of recurrent strokes and 1-year mortality rates (32.7% vs 23.2%, p=0.001). Multivariate logistic regression analysis showed that stroke is an independent predictor of in-hospital and 1-year mortality. CONCLUSIONS This observational study reports high prevalence of prior stroke in patients hospitalised with HF. Internists rather than cardiologists were the predominant caregivers in this high-risk group. Patients with stroke had higher risk of in-hospital recurrent strokes and long-term mortality rates. TRIAL REGISTRATION NUMBER NCT01467973.
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Affiliation(s)
- Hadi A R Khafaji
- Department of Cardiology, Saint Michael's Hospital, Toronto University, Canada
| | | | - Rajvir Singh
- Biostatistics Section, Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Nidal Asaad
- Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Bassam Bulbanat
- Department of Cardiology, Sabah Al-Ahmed Cardiac Center, Kuwait
| | - Wael AlMahmeed
- Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mustafa Ridha
- Department of Cardiology, Adan Hospital, Kuwait, Kuwait
| | | | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Bahrain
| | - Ahmed Al-Motarreb
- Department of Cardiology, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Hussam AlFaleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Abdelfatah Elasfar
- Department of Cardiology, Prince Salman Heart Center, King Fahad Medical City, Saudi Arabia
- Department or Cardiology, Tanta University, Tanta, Egypt
| | | | - Jassim Al Suwaidi
- Biostatistics Section, Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
- Qatar Cardiovascular Research Center and Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Munibari AN, Al-Motarreb A, Alansi A, Cimino S, La Torre G, Agati L. Reperfusion therapy for ST elevation acute myocardial infarction in Yemen: Description of the current situation: Data from Gulf Registry of Acute Coronary Events (the Gulf RACE-I). Int J Cardiol 2015; 187:128-9. [PMID: 25828333 DOI: 10.1016/j.ijcard.2015.03.348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 03/21/2015] [Indexed: 11/19/2022]
Affiliation(s)
- A-Nasser Munibari
- Cardiac Center, AlThawra Modern Teaching General Hospital, Sana'a, Yemen
| | - Ahmed Al-Motarreb
- Cardiac Center, AlThawra Modern Teaching General Hospital, Sana'a, Yemen
| | - Ahmed Alansi
- Cardiac Center, AlThawra Modern Teaching General Hospital, Sana'a, Yemen
| | - Sara Cimino
- Department of Cardiology, "Sapienza" University of Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Italy
| | - Luciano Agati
- Department of Cardiology, "Sapienza" University of Rome, Italy.
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Sulaiman K, Panduranga P, Al-Zakwani I, Alsheikh-Ali AA, AlHabib KF, Al-Suwaidi J, Al-Mahmeed W, AlFaleh H, Elasfar A, Al-Motarreb A, Ridha M, Bulbanat B, Al-Jarallah M, Bazargani N, Asaad N, Amin H. Clinical characteristics, management, and outcomes of acute heart failure patients: observations from the Gulf acute heart failure registry (Gulf CARE). Eur J Heart Fail 2015; 17:374-84. [PMID: 25739882 DOI: 10.1002/ejhf.245] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 01/11/2023] Open
Abstract
AIMS The purpose of this study was to describe the clinical characteristics, management, and outcomes of acute heart failure (HF) patients from the Gulf acute heart failure registry (Gulf CARE). METHODS AND RESULTS Data from 5005 HF patients admitted to 47 hospitals in seven Gulf countries during February to November 2012 were analysed. Fifty-five per cent of patients presented with acute decompensated chronic HF, while 45% had new-onset HF. Mean age was 59 ± 15 years, 63% were males, and 83% were Gulf citizens. Co-morbid conditions were hypertension (61%), diabetes mellitus (50%), CAD (47%), and atrial fibrillation or flutter (14%). The median LVEF was 35% (25-45%) with 69% presenting as HF with reduced EF (HFrEF). CAD was the most prevalent aetiology (53%) followed by idiopathic cardiomyopathy (18%), hypertensive heart disease (16%), and valvular heart disease (9%). At discharge, 71% and 78% of patients received beta-blockers and ACE inhibitors/ARBs, respectively. Use of coronary intervention and device therapy was <10%. In-hospital mortality was 6.3%. Re-hospitalization and cumulative mortality at 3 and 12 months were 18%/13% and 40%/20%, respectively. CONCLUSIONS Gulf CARE results show that patients from this region are a decade younger than their Western counterparts, with a high prevalence of diabetes and HFrEF, and a lower prevalence of AF. Use of coronary intervention and device therapy was low, with high re-hospitalization rates. Short- and long-term mortality rates were similar to those of Western registries, but should be interpreted in the light of the younger age of Gulf CARE patients.
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Panduranga P, Sulaiman KJ, Al-Zakwani I, Alhabib KF, Hersi A, Suwaidi JA, Alsheikh-Ali AA, Almahmeed W, Saif SA, Al-Faleh H, Al-Lawati J, Asaad N, Al-Motarreb A, Amin H. Acute Coronary Syndrome in Indian Subcontinent Patients Residing in the Middle East: Results From Gulf Registry of Acute Coronary Events II. Angiology 2014; 66:818-25. [PMID: 25381144 DOI: 10.1177/0003319714556812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We compared baseline characteristics, clinical presentation, and in-hospital outcomes between Middle Eastern Arabs and Indian subcontinent patients presenting with acute coronary syndrome (ACS). Of the 7930 patients enrolled in Gulf Registry of Acute Coronary Events II (RACE II), 23% (n = 1669) were from the Indian subcontinent. The Indian subcontinent patients, in comparison with the Middle Eastern Arabs, were younger (49 vs 60 years; P < .001), more were males (96% vs 80%; P < .001), had lower proportion of higher Global Registry of Acute Coronary Events risk score (8% vs 27%; P < .001), and less likely to be associated with diabetes (34% vs 42%; P < .001), hypertension (36% vs 51%; P < .001), and hyperlipidemia (29% vs 39%; P < .001) but more likely to be smokers (55% vs 29%; P < .001). After multivariable adjustment, the Middle Eastern Arabs were less likely to be associated with in-hospital congestive heart failure (odds ratio [OR], 0.65; 95% confidence interval [CI]: 0.50-0.86; P = .003) but more likely to be associated with recurrent ischemia (OR 1.33; 95% CI: 1.03-1.71; P = .026) when compared to the Indian subcontinent patients. Despite the baseline differences, there were largely no significant differences in in-hospital outcomes between the Indians and the Middle Eastern Arabs.
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Affiliation(s)
| | | | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman Gulf Health Research, Muscat, Oman
| | - Khalid F Alhabib
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Hersi
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jassim Al Suwaidi
- Department of Cardiology and Cardiovascular Surgery, Hamad General Hospital & Weill Cornell Medical College, Doha, Qatar
| | - Alawi A Alsheikh-Ali
- Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates Institute for Clinical Research and Health Policy Studies, Tufts University School of Medicine, Boston, MA, USA
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | | | - Hussam Al-Faleh
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jawad Al-Lawati
- Non-Communicable Diseases Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Nidal Asaad
- Department of Cardiology and Cardiovascular Surgery, Hamad General Hospital & Weill Cornell Medical College, Doha, Qatar
| | | | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Centre, Bahrain
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Panduranga P, Al-Zakwani I, Sulaiman K, AlHabib KF, Almahmeed W, Al-Jarallah M, Alsheikh-Ali A, Al-Suwaidi J, AlFaleh H, Elasfar A, Al-Motarreb A, Ridha M, Bulbanat B, Bazargani N, Asaad N, Amin H. Clinical characteristics, management and outcomes of Indian subcontinent and Middle East acute heart failure patients: Results: From the Gulf acute heart failure registry. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Shehab A, Al-Habib K, Hersi A, Al-Faleh H, Alsheikh-Ali A, Almahmeed W, Suleiman KJ, Al-Motarreb A, Suwaidy JA, Asaad N, AlSaid S, Hashim M, Amin H. Quality of care in primary percutaneous coronary intervention for acute ST-segment -elevation myocardial infarction: Gulf RACE 2 experience. Ann Saudi Med 2014; 34:482-7. [PMID: 25971820 PMCID: PMC6074571 DOI: 10.5144/0256-4947.2014.482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Primary percutaneous coronary intervention (pPCI) has been recognized as an effective management strategy for acute ST-segment-elevation myocardial infarction (STEMI). However, there is no first-hand information regarding the quality of pPCI procedures in the Arabian Gulf countries. This study aims to explore the quality of pPCI practice. DESIGN AND SETTINGS The Gulf Race II was designed as a prospective, multinational, multicentre registry of acute coronary events, focusing on the epidemiology, management practices, and outcomes of patients with acute coronary syndrome. The study recruited consecutive patients aged 18 years and above from 65 hospitals in 6 adjacent Middle Eastern countries (Bahrain, Saudi Arabia, Qatar, Oman, United Arab Emirates, and Yemen). PATIENTS AND METHODS We used data from the Gulf Registry of Acute Coronary Events (Gulf RACE 2). We analyzed data on patients who received pPCI to assess the guidelines-supported performance measure of door-to-balloon (D2B).
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Affiliation(s)
- Abdulla Shehab
- A Shehab, MD, Department of Internal Medicine,, College of Medicine and Health Sciences,, UAE University, Al Ain, United Arab Emirates, T: +971506161028,, F: +97137672 995,
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Sulaiman KJ, Panduranga P, Al-Zakwani I, Alsheikh-Ali A, Al-Habib K, Al-Suwaidi J, Al-Mahmeed W, Al-Faleh H, El-Asfar A, Al-Motarreb A, Ridha M, Bulbanat B, Al-Jarallah M, Bazargani N, Asaad N, Amin H. Rationale, Design, Methodology and Hospital Characteristics of the First Gulf Acute Heart Failure Registry (Gulf CARE). Heart Views 2014; 15:6-12. [PMID: 24949181 PMCID: PMC4062990 DOI: 10.4103/1995-705x.132137] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is paucity of data on heart failure (HF) in the Gulf Middle East. The present paper describes the rationale, design, methodology and hospital characteristics of the first Gulf acute heart failure registry (Gulf CARE). MATERIALS AND METHODS Gulf CARE is a prospective, multicenter, multinational registry of patients >18 year of age admitted with diagnosis of acute HF (AHF). The data collected included demographics, clinical characteristics, etiology, precipitating factors, management and outcomes of patients admitted with AHF. In addition, data about hospital readmission rates, procedures and mortality at 3 months and 1-year follow-up were recorded. Hospital characteristics and care provider details were collected. Data were entered in a dedicated website using an electronic case record form. RESULTS A total of 5005 consecutive patients were enrolled from February 14, 2012 to November 13, 2012. Forty-seven hospitals in 7 Gulf States (Oman, Saudi Arabia, Yemen, Kuwait, United Gulf Emirates, Qatar and Bahrain) participated in the project. The majority of hospitals were community hospitals (46%; 22/47) followed by non-University teaching (32%; 15/47 and University hospitals (17%). Most of the hospitals had intensive or coronary care unit facilities (93%; 44/47) with 59% (28/47) having catheterization laboratory facilities. However, only 29% (14/47) had a dedicated HF clinic facility. Most patients (71%) were cared for by a cardiologist. CONCLUSIONS Gulf CARE is the first prospective registry of AHF in the Middle East, intending to provide a unique insight into the demographics, etiology, management and outcomes of AHF in the Middle East. HF management in the Middle East is predominantly provided by cardiologists. The data obtained from this registry will help the local clinicians to identify the deficiencies in HF management as well as provide a platform to implement evidence based preventive and treatment strategies to reduce the burden of HF in this region.
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Affiliation(s)
| | | | - Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy, Sultan Qaboos University and Gulf Health Research, Muscat, Oman
| | - Alawi Alsheikh-Ali
- Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Khalid Al-Habib
- Department of Cardiology, King Fahad Cardiac Centre, King Khalid University Hospital, College of Medicine, Riyadh, Saudi Arabia
| | | | - Wael Al-Mahmeed
- Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Husam Al-Faleh
- Department of Cardiology and Cardiovascular Surgery, Security Forces Hospital, Riyadh, Saudi Arabia
| | | | | | | | | | | | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Nidal Asaad
- Department of Cardiology, Hamad General Hospital, Doha, Qatar
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Cardiac Centre, Bahrain
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Asaad N, El-Menyar A, AlHabib KF, Shabana A, Alsheikh-Ali AA, Almahmeed W, Al Faleh H, Hersi A, Al Saif S, Al-Motarreb A, Sulaiman K, Al Nemer K, Amin H, Al Suwaidi J. Initial heart rate and cardiovascular outcomes in patients presenting with acute coronary syndrome. ACTA ACUST UNITED AC 2014; 16:49-56. [PMID: 24702593 DOI: 10.3109/17482941.2014.889312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To assess the impact of on-admission heart rate (HR) in patients presenting with acute coronary syndrome (ACS). METHODS Data were collected retrospectively from the second Gulf Registry of Acute Coronary Events. Patients were divided according to their initial HR into: (I: < 60, II: 60-69, III: 70-79, IV: 80-89 and V: ≥ 90 bpm). Patients' characteristics and hospital and one- and 12-month outcomes were analyzed and compared. RESULTS Among 7939 consecutive ACS patients, groups I to V represented 7%, 13%, 20%, 23.5%, and 37%, respectively. Mean age was higher in groups I and V. Group V were more likely males, diabetic and hypertensive. ST-elevation myocardial infarction was the main presentation in groups I and V. Reperfusion therapies were less likely given to group V. Beta blockers were more frequently prescribed to group III in comparison to groups with higher HR. Groups I and V were associated with worse hospital outcomes. Multivariate analysis showed initial tachycardia as an independent predictor for heart failure (OR 2.2; 95%CI: 1.39-3.32), while bradycardia was independently associated with higher one-month mortality (OR 2.0; 95%CI: 1.04-3.85) CONCLUSION: The majority of ACS patients present with tachycardia. However, low or high HR is a marker of high risk that needs more attention and management.
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Affiliation(s)
- Nidal Asaad
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation , Qatar
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Salam A, AlHabib K, Sulaiman K, Alsheikh-Ali A, Almahmeed W, Amin H, Al-Lawati J, Al-Motarreb A, Singh R, Al Suwaidi J. THE EFFECT OF FEMALE GENDER ON CARDIAC ARRHYTHMIAS IN ACUTE CORONARY SYNDROMES: INSIGHTS FROM THE SECOND GULF REGISTRY OF ACUTE CORONARY EVENTS. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kashour T, Alhabib K, Alfaleh H, Hersi A, Ullah A, Alsheikhali A, Al Suwaidi J, Amin H, Al-motarreb A, Al-Motarreb A, Almahmeed W. PT165 Prediction of short and intermediate-term mortality in patients with acute coronary syndrome: Validation of the lab index in patients from the Gulf-RACE-2 registry. Glob Heart 2014. [DOI: 10.1016/j.gheart.2014.03.1939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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46
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AlHabib KF, Alfaleh H, Hersi A, Kashour T, Alsheikh-Ali AA, Suwaidi JA, Sulaiman K, Saif SA, Almahmeed W, Asaad N, Amin H, Al-Motarreb A, Thalib L. Use of emergency medical services in the second gulf registry of acute coronary events. Angiology 2013; 65:703-9. [PMID: 24019088 DOI: 10.1177/0003319713502846] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Data are scarce regarding emergency medical service (EMS) usage by patients with acute coronary syndrome (ACS) in the Arabian Gulf region. This 9-month in-hospital prospective ACS registry was conducted in Arabian Gulf countries, with 30-day and 1-year follow-up mortality rates. Of 5184 patients with ACS, 1293 (25%) arrived at the hospital by EMS. The EMS group (vs non-EMS) was more likely to be male, have cardiac arrest on presentation, be current or exsmokers, and have moderate or severe left ventricular dysfunction and ST-segment elevation myocardial infarction (STEMI). The EMS group had higher crude mortality rates during hospitalization and after hospital discharge but not after adjustment for clinical factors and treatments. The EMSs are underused in the Arabian Gulf region. Short- and long-term mortality rates in patients with ACS are similar between those who used and did not use EMS. Quality improvement in the EMS infrastructure and establishment of integrated STEMI networks are urgently needed.
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Affiliation(s)
- Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Hussam Alfaleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ahmad Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Tarek Kashour
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Alawi A Alsheikh-Ali
- Division of Cardiology, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates Tufts Clinical and Translational Science Institute, Tufts Medical Center, Boston, MA, USA
| | - Jassim Al Suwaidi
- Department of Cardiology, Hamad Medical Corporation (HMC), Doha, Qatar
| | | | - Shukri Al Saif
- Saud AlBabtain Cardiac Center, Dammam, Kingdom of Saudi Arabia
| | - Wael Almahmeed
- Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Nidal Asaad
- Department of Cardiology, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain
| | | | - Lukman Thalib
- Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait
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47
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Shehab A, Al-Dabbagh B, AlHabib K, Alsheikh-Ali A, Almahmeed W, Sulaiman K, Al-Motarreb A, Suwaidi JA, Hersi A, AlFaleh H, Asaad N, AlSaif S, Amin H, Alanbaei M, Nagelkerke N, Abdulle A. The obesity paradox in patients with acute coronary syndrome: results from the Gulf RACE-2 study. Angiology 2013; 65:585-9. [PMID: 23921507 DOI: 10.1177/0003319713497087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We investigated the association between in-hospital and peri-hospital mortality and body mass index (BMI)/waist circumference (WC) in a prospective acute coronary syndrome (ACS) registry in the Arabian Gulf. No significant associations with in-hospital mortality were found. Normal BMI had highest peri-hospital mortality, notably those with high WC. In logistic regression of mortality on obesity measures and potential confounders, the effects of obesity measures were no longer significant. In-hospital death increased by 5% with age and decreased by 42% in males. Mortality increased 3.7-fold with ST-elevation myocardial infarction (STEMI) and 3.0-fold with heart failure (HF) but decreased by 33% with dyslipidemia. Peri-hospital death increased by 4% with age and decreased by 30% in males. Mortality increased 2.8-fold with STEMI and 2.4-fold with HF. In- and peri-hospital mortality in ACS is significantly associated with age, gender, STEMI, HF, and dyslipidemia but not obesity measures.
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Affiliation(s)
- Abdulla Shehab
- Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - Bayan Al-Dabbagh
- Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - Khalid AlHabib
- King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Alawi Alsheikh-Ali
- Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates Institute for Clinical Research and Health Policy Studies, Tufts University School of Medicine, Boston, MA, USA
| | - Wael Almahmeed
- Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | | | - Ahmed Al-Motarreb
- Department of Medicine, Faculty of Medicine, Sana's University, Sana'a, Yemen
| | - Jassim Al Suwaidi
- Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Ahmad Hersi
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Hussam AlFaleh
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Nidal Asaad
- Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Shukri AlSaif
- Cardiology Department, Saud Al-Babtain Cardiac Center, Dammam, Kingdom of Saudi Arabia
| | - Haitham Amin
- Cardiology Department, Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain
| | - Muath Alanbaei
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait
| | - Nicolaas Nagelkerke
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - Abdishakur Abdulle
- Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
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48
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Ahmed E, Alhabib KF, El-Menyar A, Asaad N, Sulaiman K, Hersi A, Almahmeed W, Alsheikh-Ali AA, Amin H, Al-Motarreb A, Al Saif S, Singh R, Al-Lawati J, Al Suwaidi J. Age and clinical outcomes in patients presenting with acute coronary syndromes. J Cardiovasc Dis Res 2013; 4:134-9. [PMID: 24027372 DOI: 10.1016/j.jcdr.2012.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 08/27/2012] [Indexed: 12/22/2022] Open
Abstract
CONTEXT Elderly patients have more cardiovascular risk factors and a greater burden of ischemic disease than younger patients. AIMS To examine the impact of age on clinical presentation and outcomes in patients presenting with acute coronary syndrome (ACS). METHODS AND MATERIAL Collected data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2), which is a prospective multicenter study from six adjacent Arab Middle Eastern Gulf countries. Patients were divided into 3 groups according to their age: ≤50 years, 51-70 years and >70 years and their clinical characteristics and outcomes were analyzed. Mortality was assessed at one and 12 months. STATISTICAL ANALYSIS USED One-way ANOVA test for continuous variables, Pearson chi-square (X (2)) test for categorical variables and multivariate logistic regression analysis for predictors were performed. RESULTS Among 7930 consecutive ACS patients; 2755 (35%) were ≤50 years, 4110 (52%) were 51-70 years and 1065 (13%) >70 years old. The proportion of women increased with increasing age (13% among patients ≤50 years to 31% among patients > 70 years). The risk factor pattern varied with age; younger patients were more often obese, smokers and had a positive family history of CAD, whereas older patients more likely to have diabetes mellitus, hypertension, and dyslipidemia. Advancing age was associated with under-treatment evidence-based therapies. Multivariate logistic regression analysis after adjusting for relevant covariates showed that old age was independent predictors for re-ischemia (OR 1.29; 95% CI 1.03-1.60), heart failure (OR 2.8; 95% CI 2.17-3.52) and major bleeding (OR 4.02; 95% CI 1.37-11.77) and in-hospital mortality (age 51-70: OR 2.67; 95% CI 1.86-3.85, and age >70: OR 4.71; 95% CI 3.11-7.14). CONCLUSION Despite being higher risk group, elderly are less likely to receive evidence-based therapies and had worse outcomes. Guidelines adherence is highly recommended in elderly.
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Affiliation(s)
- Emad Ahmed
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
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Annonu A, Alwather NA, Al-Motarreb A. Very early complication of rheumatic heart disease (valvuloplasty for severe mitral valve stenosis for 6 year old male patient). J Saudi Heart Assoc 2013. [DOI: 10.1016/j.jsha.2013.03.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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50
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Al-Shami M, Al-Motarreb A. Association of khat chewing with significant coronary artery disease in patients presenting with heart failure. J Saudi Heart Assoc 2013. [DOI: 10.1016/j.jsha.2013.03.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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