pattern of acute myocardial infarction in a rapidly developed country

ABSTRACT

Cardiovascular Disease [CVD] is the leading cause of morbidity and mortality in many of the affluent Arab nations. Myocardial infarction may lead to impairment in the systolic or diastolic functions, to a prolonged pre-disposition to arrhythmias and other long-term complications. The aim of this paper was to study the pattern of Acute Myocardial Infarction [AMI] according to its site [Anterior or Inferior] and determine its predictors. This is a retrospective cohort study of all Qatari and Non-Qatari patients who were hospitalized with AMI in the Hamad General Hospital, State of Qatar from 1991 to 2003. The diagnostic classification of definite AMI was made in accordance with the criteria of the International Classification of Disease ninth revision [ICD-9]. The obtained information was based on the following parameters the patient's age at the time of admission, gender, cardiovascular risk factor profiles [smoking status, hypercholesterolemia, diabetes, and pre-existing coronary heart disease], and AMI location. Of the 3210 patients admitted with AMI, 55.6% of the patients were diagnosed with anterior AMI and 44.4% with inferior AMI. Anterior and inferior AMI was more prevalent in men in the age group [40-69] years old. 80.1% of the inferior AMI patients were in this age group which was higher than the anterior group [76.3%]. When compared with non-Qatari's; stroke and mortality rates were higher among Qataris in the anterior AMI group; whereas heart block and mortality rates were significantly higher in Inferior AMI group. Gender, hypertension and age [above 50 years] were predictors of both groups. Mortality rate was significantly higher in anterior AMI patients. The present study revealed that there is a strong association between age, risk factors and site of AMI. Patients with anterior AMI have twice the mortality rate of that of inferior AMI subjects: