No abstract

Patients with ACS in the Arab Middle East are younger than in developed countries and have higher rates of diabetes and smoking. There is good adherence to evidence-based medications; however, improvement in door-to-needle time and utilisation of interventional procedures is needed.

Of the SES measures we studied, low education was the marker most consistently associated with increased risk for AMI globally, most markedly in high-income countries.

MALL EXPERIMENTAL AND CLINIcal studies have supported the u s e o f g l u c o s e -i n s u l i npotassium (GIK) infusion in the treatment of acute ST-segment elevation myocardial infarction (STEMI). [1][2][3][4] However, the Clinical Trial of Reviparin and Metabolic Modulation in Acute Myocardial Infarction T r e a t m e n t a n d E v a l u a t i o n -Estudios Clinicos Latino America (CREATE-ECLA) 5 of 20 201 patients with acute STEMI demonstrated a neutral effect of GIK infusion on 30day mortality. A separate study, the Organization for the Assessment of Strategies for Ischemic Syndromes-6 (OASIS-6) trial, evaluated the effect of GIK infusion vs no infusion on 6-month clinical outcomes in 2748 patients with acute STEMI. The principal results of the GIK component of the OASIS-6 trial through 6 months are presented herein.

The authors explored the prevalence and impact of the cardiovascular risk factors (CVRFs) in patients presenting with acute coronary syndrome (ACS). During a five-month period in 2007, six adjacent Middle Eastern countries participated in the Gulf Registry of acute coronary events. CVRFs were identified on admission. Patients' characteristics and in-hospital outcomes were analyzed across the types of ACS. Among 6704 consecutive patients with ACS, 61% had non-ST elevation ACS (NSTEACS) and 39% had ST-elevation myocardial infarction (STEMI). Female sex, old age, diabetes mellitus, hypertension, dyslipidemia, and obesity were more prevalent in NSTEACS patients. STEMI patients were more likely to be smokers and less likely to be taking aspirin prior to the index admission. Chronic renal failure (CRF) and diabetes mellitus were independent predictors of in-hospital heart failure in NSTEACS, while CRF and hypertension were predictors of STEMI. Female sex and CRF were independent predictors of mortality in STEMI (odds ratio, 2.0; 95% confidence interval, 1.19-3.13 and odds ratio, 5.0; 95% confidence interval, 3.47-7.73, respectively). Assessment of the prevalence of CVRF in the acute coronary presentation is of important prognostic value for in-hospital morbidity and mortality. CVRF and its impact may differ according to ACS type, age, and sex. Coronary heart disease (CHD) is the leading cause of mortality and morbidity worldwide. To achieve a significant reduction in the prevalence of CHD, it is essential to adopt effective preventive strategies with adequate awareness of the epidemiology of cardiovascular risk factors (CVRFs).1 CVRFs include traditional and nontraditional factors. However, the US Preventive Services Task Force concluded that the evidence is insufficient to assess the balance of benefits and harms of using nontraditional risk factors. 2,3 The World Health Organization has recognized obesity, hypertension, hypercholesterolemia, and smoking among the top10 traditional risk factors for premature death and morbidity. 4 Since these risk factors are usually evident before developing CHD, knowledge of their prevalence in a given population allows the prediction of the likely burden of CHD. 3 The American Heart Association has recognized many risk factors; some can be modified, treated, or controlled and some can not. 5 The more risk factors present, the greater the likelihood of developing CHD. Currently, most reports for prevention of CHD are mainly derived from European centers and suggest that risk factors for CHD are varying from country to country. 6 However, data from the Arab Middle East that evaluate the prevalence and impact of these risk factors in acute coronary events are scarce. 4,7,8 We explore the prevalence of CVRFs in patients with acute coronary syndrome (ACS) who are living in the Arab Middle East and the impact of these factors on in-hospital heart failure (HF) and mortality.The authors have no funding, financial relationships, or conflicts of interest to disclose.