RESUMEN
BACKGROUND: The khat plant is a stimulant similar to amphetamine and is thought to induce coronary artery spasm. Khat is widely chewed by individuals originating from the Horn of Africa and the Arabian Peninsula. The aim of this study was to evaluate the clinical characteristics and outcome of khat chewers presenting with acute coronary syndrome. METHODS AND RESULTS: From October 1, 2008, through June, 30, 2009, 7399 consecutive patients with acute coronary syndrome were enrolled in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-2). Nineteen percent of patients were khat chewers; 81% were not. Khat chewers were older, more often male, and less likely to have cardiovascular risk factors. Khat chewers were less likely to have a history of coronary artery disease and more likely to present late and to have higher heart rate and advanced Killip class on admission. Khat chewers were more likely to present with ST-segment-elevation myocardial infarction. Overall, khat chewers had higher risk of death, recurrent myocardial ischemia, cardiogenic shock, ventricular arrhythmia, and stroke compared with non-khat chewers. After adjustment for baseline variability, khat chewing was found to be an independent risk factor of death and for recurrent ischemia, heart failure, and stroke. CONCLUSIONS: Our data confirm earlier observations of worse in-hospital outcome among acute coronary syndrome patients who chew khat. This worse outcome persists up to 1 year from the index event. This observational report underscores the importance of improving education concerning the cardiovascular risks of khat chewing.
Asunto(s)
Síndrome Coronario Agudo/epidemiología , Síndrome Coronario Agudo/mortalidad , Anfetamina/efectos adversos , Catha/efectos adversos , Preparaciones de Plantas/efectos adversos , Síndrome Coronario Agudo/etnología , Adulto , Anciano , Femenino , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/mortalidad , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Medio Oriente/epidemiología , Análisis Multivariante , Isquemia Miocárdica/epidemiología , Isquemia Miocárdica/mortalidad , Estudios Prospectivos , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/mortalidad , Tasa de SupervivenciaRESUMEN
Using data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2) in 2008-09 we investigated the in-hospital complications and 1-year outcome of acute coronary syndrome (ACS) in patients with systemic hypertension from 6 Gulf countries. Of 7847 consecutive patients admitted with ACS, 3746 (47.7%) had hypertension. Hypertension was more prevalent in women, in Arabs than non-Arabs and in older age groups. Patients with hypertension were more likely than those without hypertension to present with dyspnoea and advanced Killip class. Among hypertensive patients, the mortality rate was higher only among those admitted with ST-elevation myocardial infarction. After adjustment for baseline variables, hypertension was an independent predictive factor for heart failure (OR = 1.31) and stroke (OR = 2.47). here were no significant differences in mortality in hypertensive ACS patients when stratified by sex, age or ethnicity.
Asunto(s)
Síndrome Coronario Agudo/complicaciones , Hipertensión/complicaciones , Síndrome Coronario Agudo/epidemiología , Síndrome Coronario Agudo/etnología , Adulto , Distribución por Edad , Anciano , Árabes , Femenino , Conductas Relacionadas con la Salud , Estado de Salud , Humanos , Hipertensión/epidemiología , Hipertensión/etnología , Masculino , Persona de Mediana Edad , Medio Oriente/epidemiología , Infarto del Miocardio/complicaciones , Infarto del Miocardio/mortalidad , Alta del Paciente , Prevalencia , Distribución por Sexo , Resultado del TratamientoRESUMEN
Using data from the 2nd Gulf Registry of Acute Coronary Events [Gulf RACE-2] in 2008-09 we investigated the in-hospital complications and 1-year outcome of acute coronary syndrome [ACS] in patients with systemic hypertension from 6 Gulf countries. Of 7847 consecutive patients admitted with ACS, 3746 [47.7%] had hypertension. Hypertension was more prevalent in women, in Arabs than non-Arabs and in older age groups. Patients with hypertension were more likely than those without hypertension to present with dyspnoea and advanced Killip class. Among hypertensive patients, the mortality rate was higher only among those admitted with ST-elevation myocardial infarction. After adjustment for baseline variables, hypertension was an independent predictive factor for heart failure [OR = 1.31] and stroke [OR = 2.47]. There were no significant differences in mortality in hypertensive ACS patients when stratified by sex, age or ethnicity