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  • 1
    Online Resource
    Online Resource
    Precipitating Factors for Hospitalization with Heart Failure: Prevalence and Clinical Impact Observations from the Gulf CARE (Gulf aCute heArt failuRe rEgistry)
    S. Karger AG ; 2020
    In:  Medical Principles and Practice Vol. 29, No. 3 ( 2020), p. 270-278
    Details
    In: Medical Principles and Practice, S. Karger AG, Vol. 29, No. 3 ( 2020), p. 270-278
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 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. 〈 b 〉 〈 i 〉 Method: 〈 /i 〉 〈 /b 〉 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. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 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; 〈 i 〉 p 〈 /i 〉 = 0.005) but a higher 1-year mortality (OR 1.43; 95% CI 1.1–1.85; 〈 i 〉 p 〈 /i 〉 = 0.007). ACS was associated with higher inhospital mortality (OR 1.84; 95% CI 1.26–2.68; 〈 i 〉 p 〈 /i 〉 = 0.002) and higher 1-year mortality (OR 1.62; 95% CI 1.27–2.06; 〈 i 〉 p 〈 /i 〉 = 0.001). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Preventive and therapeutic interventions specifically directed at noncompliance with medications and ACS are warranted in our region.
    Type of Medium: Online Resource
    ISSN: 1011-7571 , 1423-0151
    URL: Article
    DOI: 10.1159/000503334
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1482963-0
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  • 2
    Online Resource
    Online Resource
    Early Stroke following Acute Myocardial Infarction: Incidence, Predictors and Outcome in Six Middle-Eastern Countries
    S. Karger AG ; 2011
    In:  Cerebrovascular Diseases Vol. 32, No. 5 ( 2011), p. 471-482
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 32, No. 5 ( 2011), p. 471-482
    Abstract: 〈 i 〉 Background and Objectives: 〈 /i 〉 Stroke is a potential complication of acute myocardial infarction (AMI). The aim of this study was to identify the incidence, risk factors predisposing to stroke and in-hospital outcome during the index admission with AMI among patients in the Middle East. 〈 i 〉 Methods: 〈 /i 〉 For a period of 6 months in 2006 and 2007, 5,833 consecutive AMI patients were enrolled from 64 hospitals in 6 Middle East countries. 〈 i 〉 Results: 〈 /i 〉 The incidence of in-hospital stroke following AMI was 0.85%. Most cases were ST segment elevation AMI-related and ischemic in nature. Patients with in-hospital stroke were older than patients without stroke and were more likely to be female (36 vs. 18.6%, p = 0.0033). They were also more likely to have diabetes mellitus, dyslipidemia, prior AMI, or percutaneous/surgical coronary revascularization. Patients with stroke were more likely to present with advanced Killip class II–IV, higher mean heart rate and higher serum creatinine. Independent predictors of stroke were age, prior stroke, prior coronary artery bypass surgery, anterior AMI and systolic blood pressure 〉 190 mm Hg on presentation. Early administration of statins was independently associated with reduced stroke risk (odds ratio, OR, 0.4, 95% confidence interval, CI, 0.19–0.90, p = 0.025). Stroke was fatal in 44% of the cases and was independently associated with in-hospital mortality (adjusted OR 12.5, 95% CI 5.7–27.4, p 〈 0.01). 〈 i 〉 Conclusion: 〈 /i 〉 There is a low incidence of in-hospital stroke in Middle-Eastern patients presenting with AMI but with very high fatality rates. Early statin therapy was associated with a significant reduction in stroke risk. Future work should be focused on reducing the risk and improving the outcome of this devastating complication.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000330344
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1482069-9
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  • 3
    Online Resource
    Online Resource
    Impact of Dual versus Single Antiplatelet Therapy on Major Cardiovascular Outcomes in Patients with Acute Coronary Syndrome in the Arabian Gulf
    S. Karger AG ; 2020
    In:  Medical Principles and Practice Vol. 29, No. 2 ( 2020), p. 181-187
    Details
    In: Medical Principles and Practice, S. Karger AG, Vol. 29, No. 2 ( 2020), p. 181-187
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To evaluate the association of dual versus single antiplatelet therapy with major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) in the Arabian Gulf. 〈 b 〉 〈 i 〉 Subjects and Methods: 〈 /i 〉 〈 /b 〉 Data were analyzed from 3,559 patients with a diagnosis of ACS admitted to 29 hospitals in 4 Arabian Gulf countries (Bahrain, Kuwait, Oman, and United Arab Emirates) from January 2012 to January 2013. Dual antiplatelet therapy (DAPT), consisting of aspirin and clopidogrel, was compared to aspirin alone. MACE included 12-months cumulative stroke/transient ischemic attack (TIA), myocardial infarction (MI), all-cause mortality, and readmissions for cardiac reasons, post discharge. Analyses were performed using multivariable logistic regression. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 74% ( 〈 i 〉 n 〈 /i 〉 = 2,634) of the patients were on DAPT. At 12-month follow-up, patients on DAPT were significantly less likely to experience MACE events (adjusted OR [aOR] 0.73; 95% CI: 0.61–0.86; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). Lower cardiovascular (CV) event rates were also consistent across the following MACE components; MI (aOR 0.66; 95% CI: 0.49–0.88; 〈 i 〉 p 〈 /i 〉 = 0.005), all-cause mortality (aOR 0.69; 95% CI: 0.51–0.94; 〈 i 〉 p 〈 /i 〉 = 0.018), and readmissions for cardiac reasons (aOR 0.79; 95% CI: 0.66–0.95; 〈 i 〉 p 〈 /i 〉 = 0.011). Conversely, DAPT was adversely associated with increased risk of stroke/TIA (aOR 1.68; 95% CI: 1.05–2.69; 〈 i 〉 p 〈 /i 〉 = 0.030). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 DAPT, compared to aspirin therapy alone, was generally associated with better CV outcomes after an ACS event. However, DAPT was adversely associated with increased risk of stroke/TIA in ACS patients in the Arabian Gulf.
    Type of Medium: Online Resource
    ISSN: 1011-7571 , 1423-0151
    URL: Article
    DOI: 10.1159/000503438
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1482963-0
    Location Call Number Limitation Availability
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