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1.
Heart Views ; 24(3): 125-135, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37584026

RESUMO

Background: Cardiovascular disease patients are more likely to be readmitted within 30 days of being discharged alive. This causes an enormous burden on health-care systems in terms of poor care of patients and misutilization of resources. Aims and Objective: This study aims to find out the risk factors associated with 30-day readmission in cardiac patients at Heart Hospital, Qatar. Methods: A total of 10,550 cardiac patients who were discharged alive within 30 days at the heart hospital in Doha, Qatar, from January 2015 and December 2019 were analyzed. The bootstrap method, an internal validation statistical technique, was applied to present representative estimates for the population. Results: Out of the 10,550 cardiac patients, there were 8418 (79.8%) index admissions and 2132 (20.2%) re-admitted at least once within 30 days after the index admission. The re-admissions group was older than the index admission group (65.6 ± 13.2 vs. 56.0 ± 13.5, P = 0.001). Multinomial regression analysis showed that females were 30% more likely to be re-admitted than males (adjusted odds ratio [aOR] 1.30, 95% confidence interval [CI]: 1.11-1.50, P = 0.001). Diabetes (aOR 1.36, 95% CI: 1.20-1.53, P = 0.001), chronic renal failure (aOR 1.93, 95% CI: 1.66-2.24, P = 0.001), previous MI (aOR 3.22, 95% CI: 2.85-3.64, P = 0.001), atrial fibrillation (aOR 2.17, 95% C.I. : 1.10-2.67, P = 0.01), cardiomyopathy (aOR 1.72, 95% CI 1.47-2.02, P = 0.001), and chronic heart failure (aOR 1.56, 95% C.I.: 1.33-1.82, P = 0.001) were also independent predictors for re-admission in the regression model. C-statistics showed these variables could predict 82% accurately hospital readmissions within 30 days after being discharged alive. Conclusion: The model was more than 80% accurate in predicting 30-day readmission after being discharged alive. The presence of five or more risk factors was found to be crucial for readmissions within 30 days. The study may help design interventions that may result in better outcomes with fewer resources in the population.

2.
Heart Views ; 22(4): 256-263, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35330652

RESUMO

Background: The vast majority of literature on atrial fibrillation (AF) is based on studies from the developed world that mainly includes Caucasian patients. Data on AF in other ethnicities is very limited. The aim of this hospital-based study is to evaluate the effect of concomitant hypertension (HTN) on the characteristics and outcomes of Middle Eastern Arab and South Asian patients with AF in the state of Qatar. Materials and Methods and Results: During the 20-year period, 3850 AF patients were hospitalized; 1483 (38.5%) had HTN, and 2367 (61.5%) without HTN. Patients with HTN were 11 years older, compared to non-HTN patients, and had a significantly higher prevalence of diabetes mellitus, chronic kidney disease, and dyslipidemia, compared to non-HTN patients. Furthermore, underlying coronary artery disease and heart failure were significantly more common but not valvular and rheumatic heart diseases which were more common in those without HTN. The rates of in-hospital mortality and stroke were significantly higher in the presence of HTN (5.3% versus 3.5%, and 0.7% versus 0.2% respectively, P = 0.001), compared to non-HTN patients. Conclusions: HTN is significantly associated with more comorbidities and worse clinical outcomes when it coexists with AF in hospitalized Middle Eastern Arab and South Asian patients.

3.
Heart Views ; 21(1): 1-2, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32082492
4.
Angiology ; 69(3): 249-255, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28367645

RESUMO

AIM OF THE STUDY: We studied the clinical profile, management, and outcomes of patients with out-of-hospital cardiac arrest (OHCA) with and without ST-elevation myocardial infarction (STEMI). METHODS: Retrospective analysis of the 20-year registry data (January 1991- June 2010) was conducted on patients with cardiac disease hospitalized at Hamad General Hospital and Qatar Heart Hospital, Doha, Qatar. RESULTS: A total of 987 patients with OHCA were admitted to the cardiology department during the study period; among them, 296 (30%) patients had STEMI. Compared to the patients with OHCA without STEMI, the patients who had OHCA with STEMI were younger (53 ± 13 vs 58 ± 16 years; P = .001), more likely to be male (78% vs 34%; P = .001), smokers (35% vs 14%) but less likely to have hypertension (30% vs 48%; P = .001), diabetes (32% vs 47%, P = .001), and chronic renal failure (3.4% vs 9%; P = .002). The use of thrombolytic treatment in patients with STEMI increased from 21.6% (period 1991-1095) to 44.4% (period 2006-2010); P = .04. CONCLUSION: Percutaneous coronary intervention had increased significantly during the last quarter of the study. There was a decline in the in-hospital mortality among patients with STEMI during the last quarter of the study.


Assuntos
Hospitalização/estatística & dados numéricos , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/terapia , Sistema de Registros , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Adulto , Idoso , Feminino , Fibrinolíticos/uso terapêutico , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/complicações , Avaliação de Processos e Resultados em Cuidados de Saúde , Intervenção Coronária Percutânea , Catar , Estudos Retrospectivos , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações
5.
Angiology ; 69(3): 212-219, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28691505

RESUMO

Atrial fibrillation (AF) with coexistent chronic kidney disease (CKD) is poorly described in the literature. We compared the presenting symptoms, clinical characteristics, treatment, and outcome of patients hospitalized with AF with and without CKD in a large clinical registry. Data of patients hospitalized with AF between 1991 and 2012 in Qatar were analyzed. Of 5201 patients hospitalized for AF, 264 (5.1%) had CKD. Patients with AF and CKD were older with higher prevalence of other comorbidities and left ventricular dysfunction and were more likely to present with shortness of breath and chest pain compared with patients with AF alone who were more likely to present with palpitation. The crude in-hospital mortality was 3 times higher in patients with dual disease. On multivariable adjustments, CKD was an independent predictor of mortality (odds ratio: 2.84; 95% confidence interval: 1.33-6.08, P = .001). Further studies are warranted to try to reduce the increased mortality observed in this high-risk population.


Assuntos
Fibrilação Atrial/complicações , Fibrilação Atrial/terapia , Hospitalização , Insuficiência Renal Crônica/epidemiologia , Idoso , Antiarrítmicos/uso terapêutico , Anticoagulantes/uso terapêutico , Fibrilação Atrial/mortalidade , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Catar , Sistema de Registros , Estudos Retrospectivos
6.
Angiology ; 68(10): 914-918, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28387126

RESUMO

Women with cardiac diseases generally have a higher mortality than men. Suggested reasons include delay in reporting to hospital, less aggressive management, and higher cardiovascular risk profiles in women. We assessed gender differences in patients hospitalized with dizziness. We retrospectively reviewed the database of patients hospitalized with acute cardiac disease in Qatar from 1991 to the end of 2010. Patients hospitalized with dizziness were analyzed; 1611 (3.8%; 95% confidence interval [CI]: 3.6%-4%) of the total N = 42 144 patients were hospitalized with dizziness during the 20 years: 410 (25.5%) females and 1201 (74.5%) males. Mean age (female 55 [16] and male 53 [16] years) was comparable ( P = .06). Women had more hypertension, diabetes mellitus, palpitation, and arrhythmia compared with men. In-hospital mortality was 3.8% (women 5.6% vs men 3.2%, P = .03). After adjusting for potential confounders, female gender remained an independent factor for increased in-hospital mortality (adjusted odds ratio: 2.2, 95% CI: 1.21-4, P = .01). In this 20-year data set from a Middle Eastern country, female gender was an independent factor associated with increased in-hospital mortality in patients hospitalized with dizziness after adjusting for confounders. Further research is warranted to confirm this novel gender difference.


Assuntos
Tontura/mortalidade , Cardiopatias/mortalidade , Mortalidade Hospitalar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Catar , Estudos Retrospectivos , Fatores Sexuais
7.
Curr Vasc Pharmacol ; 15(1): 77-83, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27550053

RESUMO

BACKGROUND: Beta-blockers reduce mortality in chronic heart failure. OBJECTIVES: To study intra-hospital mortality and adverse cardiovascular (CV) outcomes in relation to beta-blockade therapy in acute decompensated heart failure. METHODS: We retrospectively analyzed a 22-year registry of acute decompensated heart failure (ADHF) in the Middle East. RESULTS: Out of the total 8066 patients admitted for ADHF, 1242(15.4%) were on beta-blockers on admission. Among those, beta-blockers were discontinued in 26.5%. Despite the existence of less CV comorbidities in patients not treated by beta-blockers, in-hospital mortality and stroke/transient ischemic attacks rates were higher in those patients compared with patients on beta-blockers on admission (14.4 vs. 3.6%, p=0.001, 0.6 vs. 0.1%, p=0.02; respectively). Additionally, continuation of beta-blockers during acute decompensation was associated with less mortality risk (p=0.001). The use of beta-blockers on admission and discharge increased significantly with time whereas in-hospital mortality decreased (p=0.001). Nevertheless, admission year was not a predictor of reduced mortality in patients treated with beta-blockers on admission (OR 0.93, 95% CI [0.56-1.54], p=0.77). CONCLUSION: Previous beta-blockade therapy in patients presenting with ADHF decreases intra-hospital mortality and the incidence of CV events and stroke/transient ischemic attacks. Moreover, nonwithdrawal of beta-blockers during hospitalization has a favorable outcome.


Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Mortalidade Hospitalar , Acidente Vascular Cerebral/prevenção & controle , Idoso , Distribuição de Qui-Quadrado , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Catar , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Fatores de Tempo , Resultado do Tratamento
8.
Crit Pathw Cardiol ; 15(3): 126-30, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27465010

RESUMO

BACKGROUND: Gender discrepancy in the cardiovascular diseases has been evaluated in several studies. We studied the impact of gender disparity on the presentation and outcome of diabetic heart failure (DHF) patients. METHODS: A retrospective analysis was conducted including all DHF patients admitted to the Heart Hospital between 1991 and 2013. Patients' demographics, presentation, management, and hospital outcomes were analyzed and compared based on gender and age. RESULTS: Out of 8266 HF patients, 4684 (56.7%) were diabetic, of whom 1817 (39%) were females. Mean age was comparable in both genders. DHF female patients were more likely to be hypertensive (79% vs. 65%, P = 0.001) and obese (13% vs. 4.6%, P = 0.001). DHF females were less likely to receive beta-blockers and angiotensin-converting-enzyme inhibitors/angiotensinogen-receptor blockers (25% vs. 30%, P = 0.001, 54% vs. 57%, P = 0.01, respectively), but were more likely to be on insulin therapy (21% vs. 16%, P = 0.001). In-hospital atrial fibrillation (P =0.90), ventricular tachycardia (P = 0.07), stroke (P = 0.45), and cardiac arrest (P = 0.26) were comparable. Overall in-hospital mortality was comparable in both genders (P = 0.83). In age ≤50 years, male gender was associated with a 3-fold increase in death (13% vs. 4%, P = 0.01), however, this mortality difference disappeared in DHF patients aged >50 years (P = 0.62). CONCLUSIONS: In DHF, female gender is characterized by having a high prevalence of metabolic syndrome components. Also, females are more likely to have better Left ventricular ejection fraction but less likely to receive cardiovascular evidence based medications. There is no significant difference in the overall hospital mortality between both genders, however, in the younger age; males have a significantly higher mortality.


Assuntos
Diabetes Mellitus/epidemiologia , Insuficiência Cardíaca/epidemiologia , Pacientes Internados , Sistema de Registros , Medição de Risco/métodos , Feminino , Insuficiência Cardíaca/complicações , Mortalidade Hospitalar/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Catar/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Taxa de Sobrevida/tendências
9.
BMC Cardiovasc Disord ; 16: 47, 2016 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-26892533

RESUMO

BACKGROUND: Data about the use of positive inotropic agents in patients hospitalized with acute decompensated heart failure (ADHF) is limited. METHODS: The records of 8066 patients with ADHF who were hospitalized at Hamad Medical Corporation, Qatar from 1991 to 2013 were analyzed to explore demographics and clinical characteristics of the patients according to inotropic agents use. RESULTS: Eight hundred fifty eight patients [10.6%, 95% CI (10 to 11.3%)] received intravenous inotropic support. Patients receiving inotropes were more likely to be female and have preserved ejection fraction when compared to those not receiving inotropic agents. Comorbidities associated with higher likelihood of receiving inotropic treatment included acute myocardial infarction, chronic renal impairment, dyslipidemia, hypertension, obesity and hyperglycemia. Patient on inotropes were more likely to undergone percutaneous coronary intervention (PCI), intra-aortic balloon pump support and intubation. There were no differences in the mean plasma BNP and CK-MB levels between the 2 groups. Heart failure patients receiving inotropes also were more likely to have complications including ventricular tachycardia (2.0% vs. 0.9%, p = 0.003), prolonged hospital stay (8.0 vs. 5.0 days, p = 0.001), cardiac arrest (14.6% vs. 3.2%, p = 0.001) and in-hospital mortality (30.8% vs. 9.1 %, p = 0.001). Over the study period there was an increase use of inotropic agents and decreased mortality rates. CONCLUSION: Inotropic use increased over the period whereas; female gender and conventional cardiac risk factors were predictors of inotropic agents use in the study.


Assuntos
Cardiotônicos/uso terapêutico , Parada Cardíaca/epidemiologia , Insuficiência Cardíaca/tratamento farmacológico , Hospitalização , Sistema de Registros , Taquicardia Ventricular/epidemiologia , Doença Aguda , Administração Intravenosa , Idoso , Comorbidade , Creatina Quinase Forma MB/sangue , Progressão da Doença , Dislipidemias/epidemiologia , Feminino , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/epidemiologia , Mortalidade Hospitalar , Humanos , Hiperglicemia/epidemiologia , Hipertensão/epidemiologia , Balão Intra-Aórtico/estatística & dados numéricos , Intubação Intratraqueal/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Peptídeo Natriurético Encefálico/sangue , Obesidade/epidemiologia , Intervenção Coronária Percutânea/estatística & dados numéricos , Crescimento Demográfico , Catar/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Respiração Artificial , Estudos Retrospectivos
11.
Future Cardiol ; 10(3): 337-48, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24976471

RESUMO

AIMS: To evaluate the presentation and outcome of South Asian (SAP) to Middle Eastern Arabs (MEAP) patients presenting with acute coronary syndrome. METHODS: Data were collected retrospectively in Qatar between 1991 and 2010, and were analyzed according to patient ethnicity. RESULTS: Of 14,593 acute coronary syndrome patients, 49% were MEAP and 51% were SAP. When compared with MEAP, SAP were younger, males and smokers (p < 0.01). Other cardiovascular risk factors were less common in SAP when compared with MEAP. ST-elevation myocardial infarction and the use of evidence-based medications were more prevalent among SAP (all p < 0.001). Compared to MEAP, SAP had better in-hospital outcomes; however, ethnicity was not an independent predictor of in-hospital mortality. CONCLUSION: In contrary to data from Western countries, SAP living in the Middle East are younger with lower cardiovascular risk profile and better outcomes when compared with Arab patients. However, further studies are warranted.


Assuntos
Síndrome Coronariana Aguda/etnologia , Etnicidade , Sistema de Registros , Medição de Risco/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências
12.
Cardiol Res Pract ; 2014: 464323, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24868481

RESUMO

We aimed to define the temporal trend in the initial Acute Myocardial Infarction (AMI) management and outcome during the last two decades in a Middle Eastern country. A total of 10,915 patients were admitted with initial AMI with mean age of 53 ± 11.8 years. Comparing the two decades (1991-2000) to (2001-2010), the use of antiplatelet drugs increased from 84% to 95%, ß -blockers increased from 38% to 56%, and angiotensin converting enzyme inhibitors (ACEI) increased from 12% to 36% (P < 0.001 for all). The rates of PCI increased from 2.5% to 14.6% and thrombolytic therapy decreased from 71% to 65% (P < 0.001 for all). While the rate of hospitalization with Initial MI increased from 34% to 66%, and the average length of hospital stay decreased from 6.4 ± 3 to 4.6 ± 3, all hospital outcomes parameters improved significantly including a 39% reduction in in-hospital Mortality. Multivariate logistic regression analysis showed that higher utilization of antiplatelet drugs, ß -blockers, and ACEI were the main contributors to better hospital outcomes. Over the study period, there was a significant increase in the hospitalization rate in patients presenting with initial AMI. Evidence-based medical therapies appear to be associated with a substantial improvement in outcome and in-hospital mortality.

15.
Libyan J Med ; 8(1): 20185, 2013 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-23517754

RESUMO

BACKGROUND: Mortality from cardiovascular disease in the Middle East is projected to increase substantially in the coming decades. The prevalence of metabolic syndrome (MS) in acute coronary syndrome (ACS) continues to raise interest, but data from the Middle East is limited, especially in non-diabetic patients. This study was conducted to ascertain the prevalence of MS and frequency of its components, individually and in combination, in a male population presenting with ACS, but without a previous diagnosis of diabetes mellitus (DM). METHODS: This is a prospective study of 467 consecutive male patients hospitalized for ACS. They were categorized according to the specific criteria stated in the latest joint statement for the global definition of MS. RESULTS: The mean age was (49.7±10.7 years). Of the 467 patients, 324 (69.4%) fulfilled the criteria for MS. ST-Elevation Myocardial Infarction (STEMI) was identified in 178 patients (54.9%), and non-ST elevation ACS (NSTE-ACS) in 146 patients (45.1%). These proportions were not significantly different from those without MS (STEMI 51.7% vs. NSTE-ACS 48.3%, respectively). However, patients with MS were older (50.6±10 vs. 47.9±11 years; p=0.012), and more than half of those with MS were above 50 years. The most common abnormal metabolic components were reduced high-density lipoprotein cholesterol (HDL-c; 94.1%), elevated fasting blood glucose (FBG; 89.8%), and elevated triglycerides (81.8%), followed by increased waist circumference (61.7%) and raised blood pressure (40.4%). The majority of patients with MS had three or more metabolic components (326 patients, 69.4%), and 102 (21.8%) had two components, but only 37 (8.4%) had a single component. CONCLUSIONS: In ACS patients, without previous history of DM, MS is highly prevalent. Reduced HDL, elevated FBG and triglycerides were the most frequent metabolic components. The majority had multiple components. These findings raise alarm and show that drug therapy alone may not be fully effective, unless the underlying risk factors causing MS, such as weight and exercise, are also tackled.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Síndrome Metabólica/epidemiologia , Síndrome Coronariana Aguda/sangue , Adulto , Glicemia/análise , Pressão Sanguínea , Índice de Massa Corporal , HDL-Colesterol/sangue , Hospitalização , Humanos , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Catar/epidemiologia , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura
16.
Int J Cardiol ; 168(2): 975-80, 2013 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-23159409

RESUMO

BACKGROUND: Most of the published research on atrial fibrillation (AF) is limited to studies in the developed world and included mainly Caucasian patients. Data about women with AF among other ethnicities is very limited. OBJECTIVES: The aim of this study was to compare the clinical characteristics, treatment and outcome of women to men hospitalized with AF in a middle-eastern country. METHODS: Retrospective analysis of prospective registry of all patients hospitalized with AF in Qatar from 1991 through 2010 was made. Clinical characteristics, management, and outcomes of AF patients were compared according to gender. RESULTS: During the 20-years period; 1417 women and 2432 men were hospitalized for AF. Women were 5 years older and more likely to have diabetes mellitus, hypertension, and chronic renal impairment and were also less likely to be current smokers and to have ischemic heart disease and impaired left ventricular function when compared to men. There was no gender preference in the use of anticoagulation. The prevalence of concomitant ischemic heart disease and hypertension increased, while the prevalence of valvular heart disease and heart failure decreased among patients hospitalized with AF over the study period. In-hospital mortality and stroke rates were comparable between the two groups. CONCLUSIONS: Women hospitalized with atrial fibrillation were older in age and had higher prevalence of co-morbid cardiovascular risk factors compared to men whereas, mortality and stroke rates were comparable.


Assuntos
Fibrilação Atrial/diagnóstico , Fibrilação Atrial/etnologia , Hospitalização/tendências , Sistema de Registros , Caracteres Sexuais , Adulto , Idoso , Anticoagulantes/uso terapêutico , Fibrilação Atrial/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Catar/etnologia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
17.
Angiology ; 64(7): 498-504, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23028177

RESUMO

A prospective registry was made of all patients hospitalized with atrial fibrillation (AF) in the State of Qatar from 1991 to 2010. Clinical characteristics, management, and outcomes were compared according to ethnicity (Middle Eastern Arab vs South Asian). During this 20-year period, 2857 Arabs and 548 Asians were hospitalized for AF. Arabs were 9 years older and more likely to have hypertension, diabetes mellitus (DM), chronic renal impairment, and dyslipidemia than the Asians. Valvular heart disease and acute coronary syndromes were more common among Asians, while congestive heart failure was more common in Arabs. The overall inhospital mortality was lower in Asians than that of Arabs, while stroke rates were comparable. There was an increase in the prevalence of DM and hypertension in both the groups in the latter years of the study period, but there was no change in mortality trends. Our findings underscore the need to study AF according to ethnicity.


Assuntos
Fibrilação Atrial/tratamento farmacológico , Adulto , Idoso , Árabes , Povo Asiático , Fibrilação Atrial/etnologia , Fibrilação Atrial/mortalidade , Feminino , Mortalidade Hospitalar/etnologia , Mortalidade Hospitalar/tendências , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Catar/epidemiologia , Sistema de Registros , Taxa de Sobrevida
18.
Aging Clin Exp Res ; 24(6): 682-90, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23211770

RESUMO

BACKGROUND: Most studies on atrial fibrillation (AF) epidemiology, treatment, and outcomes have included mainly Caucasians patients. The world literature on AF in other ethnicities is very limited particularly in the elderly. AIMS: The aim of this study was to compare the clinical characteristics, treatment and outcome of elderly and younger patients hospitalized with AF in a Middle-Eastern country and examine the trends of AF etiologies over a 20-year period. METHODS: A retrospective analysis of a prospective registry of all patients hospitalized with AF in Qatar from 1991 through 2010 was made. Patients were divided into three groups; group 1: patients ≤50 years old, group 2: patients between 51 and 70 years old, and group 3: patients >70 years old. Clinical characteristics, management, and outcomes of AF patients were compared according to age. RESULTS: Between the year 1991 and the end of 2010, a total 3848 consecutive patients were admitted with AF. One thousand three hundred and forty-five patients were ≤50 years, 1759 were between 51 and 70 years and 744 patients were >70 years old. Elderly patients were more likely to have hypertension and chronic renal impairment. There was a higher prevalence of associated coronary artery disease and aortic stenosis in elderly patients with a lower left ventricular ejection fraction than the younger age groups. A lower use of anticoagulation in the elderly group was observed but there was no underuse of other evidence-based medications. The older AF patients had significantly higher in-hospital mortality and stroke rates with no significant changes in mortality trends over the 20 years of study. An increasing trend of the associated acute coronary syndromes, hypertension and diabetes mellitus prevalence was observed in the elderly group. CONCLUSION: Anticoagulation remains underutilized in elderly patients with AF despite proven efficacy and increasing trends of cardiovascular comorbidities. The current study underscores the urgent need for prospective studies to investigate warfarin contraindications, relative warfarin efficacy and bleeding risks in our region to help guide healthcare providers in warfarin prescribing in this frail patient population and consequently reduce the risk of AF-related disabling strokes and mortality.


Assuntos
Fibrilação Atrial/tratamento farmacológico , Fatores Etários , Idoso , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Fibrilação Atrial/mortalidade , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Catar/epidemiologia , Sistema de Registros , Fatores de Tempo , Resultado do Tratamento , Varfarina/uso terapêutico
19.
Congest Heart Fail ; 18(6): 320-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22507267

RESUMO

The association between age, risk factors, and outcome of non-Caucasian patients hospitalized with heart failure (HF) is not clear. A total of 7066 consecutive patients hospitalized with HF at Hamad General Hospital, Doha, Qatar, from 1991 through 2010 were studied. Patients were divided into 3 groups according to age: group 1, 50 years and younger; group 2, older than 50 and up to 70 years; and group 3, older than 70 years. The prevalence of hypertension, chronic renal impairment, and atrial fibrillation increased with increased age. On admission, the older the age of the HF patient, the less likely they were to receive ß-blockers and vasodilators. In-hospital mortality rate was higher in older patients when compared with the younger groups (10.6% group 3 vs 7% group 1 and 7.2% group 2; P=.001). During the study period, the relative reduction in mortality rates was higher in the younger when compared with the older patients (55%, 49%, and 41%, respectively). The clinical characteristics of Middle-Eastern HF patients vary considerably according to age. Over time, an overall marked improvement in hospital survival for HF was observed, which was associated with progressively increased treatment with evidence-based therapies. This survival improvement over time appears to be less pronounced in the elderly.


Assuntos
Insuficiência Cardíaca/tratamento farmacológico , Sistema de Registros , Antagonistas Adrenérgicos beta/uso terapêutico , Fatores Etários , Idoso , Anti-Hipertensivos/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Diuréticos/uso terapêutico , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Catar , Resultado do Tratamento , Vasodilatadores/uso terapêutico
20.
Acute Card Care ; 14(2): 81-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22295893

RESUMO

INTRODUCTION: The clinical characteristics and outcome of patients hospitalized with heart failure vary according to ethnicities. BACKGROUND: Limited epidemiologic data are available about the clinical characteristics and outcome of heart failure (HF) patients among non-Caucasian populations. METHODS: Between 1 January 1991 and 31 December 2010; 41 453 consecutive patients were hospitalized at Hamad General Hospital, Doha, Qatar for cardiac reasons. Patients were into two groups; hospitalized with HF (n = 7069) and hospitalized for non-HF (no-HF). Among HF patients Sub-analysis was made according to ethnicity; Middle-eastern Arabs (MEA) (n = 5227) versus South Asian (SA) (n = 1289) patients. RESULTS: HF patients were older and more likely to be female when compared to non-HF patients. HF patients were also more likely to have diabetes mellitus (DM), hypertension (HTN), atrial fibrillation (AF) and renal impairment when compared to non-HF patients. SA HF patients younger and less likely to have DM, HTN and AF when compared to MEA patients. Over the 20-years period there was decrease in in-hospital mortality and stroke rates regardless of ethnicity (death; 8.3% to 4.8%, stroke; 0.8% to 0.1%; all P = 0.001). CONCLUSION: HF patients in the Middle East present at relatively younger age regardless of ethnicity. In-hospital mortality and stroke rates decreased significantly over the 20-years.


Assuntos
Insuficiência Cardíaca/etnologia , Mortalidade Hospitalar/etnologia , Adulto , Fatores Etários , Idoso , Árabes , Ásia/etnologia , Povo Asiático , Feminino , Insuficiência Cardíaca/epidemiologia , Mortalidade Hospitalar/tendências , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Catar/epidemiologia , Sistema de Registros , Fatores de Risco , Fatores Sexuais , Resultado do Tratamento
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