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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Response to Letters Regarding Article, “Acute Coronary Syndrome and Khat Herbal Amphetamine Use: An Observational Report”

Circulation (2012)

Waleed Ali Rajvir Singh Nidal Asaad Awad Al‐Qahtani Jassim Al Suwaidi

Khat

10.1161/circulationaha.112.115543

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Remarkable reduction in cardiac mortality associated with the introduction of the Strategic Cardiac Hajj Interventional Program during the largest gathering in the planet

Journal of the Saudi Heart Association (2012)

Khalid Al Faraidy Owayed Al Shammeri Fayez Bukhari Hussam Al Faleh

Religious pilgrimage, or Hajj, is a basic tenet of the Islamic doctrine. Each year approximately 3 million pilgrims congregate for up to 2 weeks in a <3 square mile area around the city of Makkah. Hajjis can experience physical and emotional stress with limited healthcare access. Cardiovascular events were the main cause of death during Hajj for the last decade; therefore the Strategic Cardiac Hajj Interventional Program(SCHIP) was launched in 2009 to provide improved cardiac outcomes. To assess the impact of SCHIP on cardiac mortality during Hajj. A team of Cardiologists, specialists, nurses with access to three cardiac catherization laboratories provided 24-h-a-day support to 13 local hospitals throughout the Hajj period. Cardiac and all causes mortality adjusting for the potential other covariates were statistically analyzed using time series data before and after intervention. Cardiac death rates during 2006, 2007 and 2008 were 51.7%, 50.6% and 53.2%. After SCHIP introduction rates in 2009, 2010 and 2011 were 27%, 32.5% and 21.5%. The in-hospital mortality for ACS were 4.7%, 4.6% and 3.0%. The number of cardiac procedure performed in 2 weeks during Hajj 2009, 2010, and 2011 were 183, 288 and 550. The majority of the procedure in the last 3 years were coronary catherization 90.1%, 80.9% and 86.7% . The rates of open heart surgery were 7%, 5.2% and 4.5% . After introduction of SCHIP, cardiac and in-hospital mortality substantially reduced. Future introduction of mobile cardiac catherization laboratories may further reduce cardiac mortality.

Hajj

10.1016/j.jsha.2012.06.203

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