Hussam Al Faleh

Saudi Heart Association

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Nidal Asaad

Hamad Medical Corporation

Wael Almahmeed

Cleveland Clinic

Jassim Al Suwaidi

Hamad Medical Corporation

Ahmad Hersi

Jamhuriya University of Science and Technology

Ahmed Al‐Motarreb

Sana'a University

Shukri Al Saif

Saud Al-babtain Cardiac Centre

Khalid F. AlHabib

King Saud University

Kadhim Sulaiman

Royal Hospital

Haitham Amin

Assiut University

Alawi Alsheikh‐Ali

Mohammed Bin Rashid University of Medicine and Health Sciences

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Hamad Medical Corporation

Royal Hospital

King Saud University

Shaikh Khalifa Medical City

Ministry of Health

Security Forces Hospital

Weill Cornell Medical College in Qatar

Sana'a University

Saud Al-babtain Cardiac Centre

King Khalid University Hospital

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OP-003: SHORT AND LONG-TERM MORTALITY ASSOCIATED WITH VENTRICULAR ARRHYTHMIA IN PATIENTS HOSPITALIZED WITH ACUTE CORONARY SYNDROME. FINDINGS FROM THE GULF RACE REGISTRY-2

International Journal of Cardiology (2011)

Ahmad Hersi Khalid F. AlHabib Hussam Al Faleh S. Alsaif Kadhim Sulaiman

10.1016/s0167-5273(11)70115-2

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Impact of Anemia on In-Hospital, One-Month and One-Year Mortality in Patients with Acute Coronary Syndrome from the Middle East

Clinical Medicine & Research (2012)

Kadhim Sulaiman Prashanth Panduranga Ibrahim Al‐Zakwani Wael Almahmeed Ahmed Al‐Motarreb

Kadhim Sulaiman*⇓, Panduranga Prashanth*, Ibrahim Al-Zakwani†, Wael Al-Mahmeed‡, Ahmed Al-Motarreb§, Jassim Al Suwaidi¶, Haitham Amin||, Nidal Asaad¶, Ahmad Hersi**, Hussam Al Faleh**, Shukri Al Saif††, Alawi A. Alsheikh-Aliत, Jawad Al Lawati¶¶ and Khalid Al-Habib** Department of Cardiology, Royal Hospital, Muscat, Oman Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman and Gulf Health Research, Muscat, Oman Division of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates Faculty of Medicine, Sana's University, Sana'a, Yemen Hamad Medical Corporation, Doha, Qatar Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain King Fahad Cardiac Centre, King Saud University, Riyadh, Kingdom of Saudi Arabia Saud Al-Babtain Cardiac Centre, Dammam, Saudi Arabia Tufts Clinical and Translational Science Institute, Tufts University School of Medicine, Boston, Massachusetts, USA Department of Non-Communicable Diseases Surveillance and Control, Ministry of Health, Muscat, Oman Corresponding Author: Dr. Kadhim Sulaiman; Department of Cardiology; Royal Hospital; PO Box 1331; Muscat PC-111; Sultanate of Oman; Phone: +968-99360025; Fax: +968-24697727; Email: kjsulaiman{at}hotmail.com

Christian ministry

Abu dhabi

10.3121/cmr.2011.1032

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Prior Antiplatelet Use and Cardiovascular Outcomes in Patients Presenting with Acute Coronary Syndromes

American Journal of Cardiovascular Drugs (2012)

Ayman El‐Menyar Khalid F. AlHabib Ahmed Al‐Motarreb Ahmad Hersi Hussam Al Faleh

Unstable angina

10.2165/11597580-000000000-00000

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Citations (4)

SHA 050. Effect of age in patient with acute coronary syndrome in SPACE registry

Journal of the Saudi Heart Association (2011)

Fayez El Shaer Khalid A. Habib A. Hersi Hussam Al Faleh Harvey W. Baker

the other presented at 5 months of age with profound cyanosis and left heart dilatation without congenital heart disease and without lung hypoplasia, both patients underwent successful occlusion of the fistula by amplatzer occluding devices with normalization of saturation without complications at five years of follow up. Conclusion: Diagnosis of large pulmonary fistula is feasible in the fetus and early infancy with excellent outcome by catheter intervention in absence of congenital heart disease or lung hypoplasia.

10.1016/j.jsha.2011.02.051

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Clinical profile and mortality of ST-Segment elevation myocardial- infarction patients receiving thrombolytic -Therapy in the Middle East

Heart Views (2012)

Prashanth Panduranga Ibrahim Al‐Zakwani Kadhim Sulaiman Khalid F. AlHabib Jassim Al Suwaidi

Little is known about thrombolytic therapy patterns in patients with ST-elevation myocardial infarction (STEMI) in the Middle East. The objective of this study was to evaluate the clinical profile and mortality of STEMI patients who arrived in hospital within 12 hours from pain onset and received thrombolytic therapy.This was a prospective, multinational, multi-centre, observational survey of consecutive acute coronary syndrome patients admitted to 65 hospitals in six Middle Eastern countries during the period between October 2008 and June 2009, as part of Gulf RACE-II (Registry of Acute Coronary Events). Analyses were performed using univariate statistics.Out of 2,465 STEMI patients, 66% (n = 1,586) were thrombolysed with namely: streptokinase (43%), reteplase (44%), tenecteplase (10%), and alteplase (3%). 22.7% received no reperfusion. Median age of the study cohort was 50 (45-59) years with majority being males (91%). The overall median symptom onset-to-presentation and door-to-needle times were 165 (95- 272) minutes and 38 (24-60) minutes, respectively. Generally, patients presenting with higher GRACE risk scores were treated with newer thrombolytic agents (reteplase and tenecteplase) (P < 0.001). The use of newer thrombolytic agents was associated with a significantly lower mortality at both 1-month (0.8% vs. 1.7% vs. 4.2%; P = 0.014) and 1-year (0% vs. 1.7% vs. 3.4%; P = 0.044) compared to streptokinase use.Majority of STEMI patients from the Middle East were thrombolysed with streptokinase and reteplase in equal numbers. Nearly one-fifth of patients did not receive any reperfusion therapy. There was inappropriately long symptom-onset to hospital presentation as well as door-to-needle times. Use of newer thrombolytic agents in high risk patients was appropriate. Newer thrombolytic agents were associated with significantly lower mortality at 1-month and 1-year compared to the older agent, streptokinase.

Elevation (ballistics)

10.4103/1995-705x.99224

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Coronary Heart Disease Acute Coronary Syndrome and Khat Herbal Amphetamine Use An Observational Report

Waleed Ali Ahmed Al‐Motarreb Rajvir Singh Ahmad Hersi Hussam Al Faleh

Khat

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Initial heart rate and cardiovascular outcomes in patients presenting with acute coronary syndrome

Acute Cardiac Care (2014)

Nidal Asaad Ayman El‐Menyar Khalid F. AlHabib Adel Shabana Alawi Alsheikh‐Ali

Objectives: To assess the impact of on-admission heart rate (HR) in patients presenting with acute coronary syndrome (ACS).Methods: Data were collected retrospectively from the second Gulf Registry of Acute Coronary Events. Patients were divided according to their initial HR into: (I: < 60, II: 60–69, III: 70–79, IV: 80–89 and V: ≥ 90 bpm). Patients' characteristics and hospital and one- and 12-month outcomes were analyzed and compared.Results: Among 7939 consecutive ACS patients, groups I to V represented 7%, 13%, 20%, 23.5%, and 37%, respectively. Mean age was higher in groups I and V. Group V were more likely males, diabetic and hypertensive. ST-elevation myocardial infarction was the main presentation in groups I and V. Reperfusion therapies were less likely given to group V. Beta blockers were more frequently prescribed to group III in comparison to groups with higher HR. Groups I and V were associated with worse hospital outcomes. Multivariate analysis showed initial tachycardia as an independent predictor for heart failure (OR 2.2; 95%CI: 1.39–3.32), while bradycardia was independently associated with higher one-month mortality (OR 2.0; 95%CI: 1.04–3.85)Conclusion: The majority of ACS patients present with tachycardia. However, low or high HR is a marker of high risk that needs more attention and management.

10.3109/17482941.2014.889312

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Acute Coronary Syndrome and Khat Herbal Amphetamine Use

Circulation (2011)

Waleed Ali Khatera Habib Ahmed Al‐Motarreb Rajvir Singh Ahmad Hersi

The khat plant is a stimulant similar to amphetamine and is thought to induce coronary artery spasm. Khat is widely chewed by individuals originating from the Horn of Africa and the Arabian Peninsula. The aim of this study was to evaluate the clinical characteristics and outcome of khat chewers presenting with acute coronary syndrome.From October 1, 2008, through June, 30, 2009, 7399 consecutive patients with acute coronary syndrome were enrolled in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-2). Nineteen percent of patients were khat chewers; 81% were not. Khat chewers were older, more often male, and less likely to have cardiovascular risk factors. Khat chewers were less likely to have a history of coronary artery disease and more likely to present late and to have higher heart rate and advanced Killip class on admission. Khat chewers were more likely to present with ST-segment-elevation myocardial infarction. Overall, khat chewers had higher risk of death, recurrent myocardial ischemia, cardiogenic shock, ventricular arrhythmia, and stroke compared with non-khat chewers. After adjustment for baseline variability, khat chewing was found to be an independent risk factor of death and for recurrent ischemia, heart failure, and stroke.Our data confirm earlier observations of worse in-hospital outcome among acute coronary syndrome patients who chew khat. This worse outcome persists up to 1 year from the index event. This observational report underscores the importance of improving education concerning the cardiovascular risks of khat chewing.

Khat

Killip class

10.1161/circulationaha.111.039768

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Gender Disparities in the Presentation, Management and Outcomes of Acute Coronary Syndrome Patients: Data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2)

PLoS ONE (2013)

Abdulla Shehab Bayan Al-Dabbagh Khalid F. AlHabib Alawi Alsheikh‐Ali Wael Almahmeed

Background Gender-related differences in mortality of acute coronary syndrome (ACS) have been reported. The extent and causes of these differences in the Middle-East are poorly understood. We studied to what extent difference in outcome, specifically 1-year mortality are attributable to demographic, baseline clinical differences at presentation, and management differences between female and male patients. Methodology/Principal Findings Baseline characteristics, treatment patterns, and 1-year mortality of 7390 ACS patients in 65 hospitals in 6 Arabian Gulf countries were evaluated during 2008–2009, as part of the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2). Women were older (61.3±11.8 vs. 55.6±12.4; P<0.001), more overweight (BMI: 28.1±6.6 vs. 26.7±5.1; P<0.001), and more likely to have a history of hypertension, hyperlipidemia or diabetes. Fewer women than men received angiotensin-converting enzyme inhibitors (ACE), aspirin, clopidogrel, beta blockers or statins at discharge. They also underwent fewer invasive procedures including angiography (27.0% vs. 34.0%; P<0.001), percutaneous coronary intervention (PCI) (10.5% vs. 15.6%; P<0.001) and reperfusion therapy (6.9% vs. 20.2%; P<0.001) than men. Women were at higher unadjusted risk for in-hospital death (6.8% vs. 4.0%, P<0.001) and heart failure (HF) (18% vs. 11.8%, P<0.001). Both 1-month and 1-year mortality rates were higher in women than men (11% vs. 7.4% and 17.3% vs. 11.4%, respectively, P<0.001). Both baseline and management differences contributed to a worse outcome in women. Together these variables explained almost all mortality disparities. Conclusions/Significance Differences between genders in mortality appeared to be largely explained by differences in prognostic variables and management patterns. However, the origin of the latter differences need further study.

10.1371/journal.pone.0055508

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Abstract P438: Cardio-Renal Anemia Syndrome in acute heart failure patients: An Observational data from “Gulf-CARE” Heart Failure Registry

Hypertension (2017)

Mohammed Al‐Jarallah Rajesh Rajan Ahmad Alsaber Raja Dashti Bassam Bulbanat

Aims: Cardio renal anemia syndrome is a condition (CRAS) where heart failure, anemia and renal failure co-exist. The purpose of this article is to measure and analyze the role of CRAS in acute heart failure in terms of left ventricular (LV) systolic function. Subjects & Methods: Gulf aCute heArt failuRe rEgistry (Gulf-CARE) study analyzed 5005 consecutive patients admitted with AHF to 47 hospitals in middle-eastern Gulf countries between 14 February and 14 November 2012. Out of which we analyzed the data of patients with CRAS and divided into two groups. The first group G1 that consists of CRAS patient with ejection fraction (EF) less than 40%, where the second group G2 that consists of CRAS patient with ejection fraction (EF) more than 40%. Chi-square test of independence was utilized for G1 and G2. Results: Out of total study population of 5005 patients, 26.8 % (1343) were identified as CRAS patients. Anemia was observed in 54.5% (2728/5005) and chronic kidney disease (CKD) in 45.1% (2257/5005) patients. G1 had 743 patients, and G2 had 600 patients. It was overserved that in G1, around 40.4% (300) were in NYHA Class IV, where G2 has only 28.8 % (173) with a p value=0.001. Cardiogenic shock, Intubation, and major bleeding were reported almost same in both groups. In-hospital stroke was seen more in G1 1.6% (12) when compared to GII 0.8% (5) without any statistical significance ( p =0.20). Out of total CRAS patients, 36.6% (491/1343) had dialysis. Mortality rates were almost similar in both groups 6.1% (45) in GI and 6.7% (40) in GII. Conclusions: In the setting of acute heart failure in CRAS patients LV function has no significant role in the incidence of in-hospital stroke, major bleeding and death.

10.1161/hyp.70.suppl_1.p438

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