In-hospital complications and 1-year outcome of acute coronary syndrome in patients with hypertension: findings from the 2nd Gulf registry of acute cardiac events

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

Racial variation in clinical characteristic and outcome in patients presenting with acute myocardial infarction: comparison between Qatari and South Asian patients in Qatar

South Asians [SA] from the Indian Subcontinent are known to have coronary artery disease [CAD] at a very young age and also to have a more diffuse disease when compared to indigenous patients in the Western world. The aim of the study was to compare clinical characteristics and outcome of South Asian patients to Qatari patients presenting with acute myocardial infarction [AMI] in Qatar. The majority of SA residing in Qatar are manual workers of lower socioeconomic status when compared to the Qatari population. We conducted a retrospective analysis of a prospectively collected data of all patients diagnosed with acute myocardial infarction [AMI] in the State of Qatar during ten years [1991 -2001]. Patients were divided into two groups: Qataris [1598 patients] and South Asians [2606 patients]. Diagnostic classification of definite AMI was made in accordance with criteria based on the International Classification of Disease ninth revision [ICD-9]. The obtained information was based on the following parameters: age at the time of admission, gender, cardiovascular risk factor profiles [smoking, hypercholesterolemia, diabetes, and pre-existing coronary heart disease], and ECG. Data analyses were performed using univariate and stepwise logistic regression analysis. When compared to Qatari patients, SA patients were younger [47 yrs vs 61 yrs; p < 0.0001]. SA were more likely to be smokers [50.5% vs 23.4%; p < 0.0001] and male [96.9% vs 71.8% p < 0.0001]. SA were less likely to have: diabetes mellitus [24.8% vs 54.0%; p < 0.0001]; hypertension [19.9% vs 37.6%; p < 0.0001]; previous MI [8.1% vs 15.8%; p < 0.0001]; CABG [2.2% vs 3.9%; p = 0.002]. The number of patients who received thrombolytic therapy was significantly higher among SA when compared to Qatari [54.6% vs 25.9%; p < 0.0001], and this was significantly associated with lower in-hospital mortality rate [6.7% vs 16.8%; p < 0.0001]. SA patients who had AMI in Qatar had better outcome than Qataris. This may be explained by the patients' favorable baseline clinical characteristics such as younger age and less prevalence of diabetes and hypertension