A registry of acute myocardial infarction in Kuwait: Patient characteristics and practice patterns
Mohammad Zubaid1, Wafa A Rashed, Mohammad Husain
1Department of Medicine, Mubarak Al-Kabeer Hospital, Safat, Kuwait. zubaid@hsc.kuniv.edu.kw
Insights
This study tracked acute myocardial infarction (AMI) patients in Kuwait, finding a young population with high rates of diabetes and smoking. Treatment with thrombolytics was appropriate, but ACE inhibitors and statin use needs improvement.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Coronary artery disease (CAD) is a leading cause of mortality in Kuwait.
- Limited data exists on patient characteristics and clinical practices for CAD in Kuwait.
Purpose of the Study:
- To establish a national registry for acute myocardial infarction (AMI) cases in Kuwait.
- To determine the characteristics and management patterns of AMI patients.
Main Methods:
- Prospective enrollment of all AMI patients admitted to coronary care units in five Kuwaiti hospitals over six months.
- Data collection on patient demographics, medical history, treatment, and outcomes.
Main Results:
- Registry included 662 patients; 87% were male, mean age 55. High prevalence of diabetes (41%), hypertension (35%), smoking (49%), and hypercholesterolemia (56%).
- 80% had ST-segment elevation AMI. Thrombolytic therapy was administered to 97% of eligible patients (median time 45 min).
- Discharge medications included aspirin (98%), beta-blockers (86%), ACE inhibitors (51%), and statins (50%). In-hospital mortality was 6.2%.
Conclusions:
- The Kuwaiti AMI patient population is characterized by young age and high rates of cardiovascular risk factors.
- Thrombolytic therapy is widely used, but treatment delays require attention. Aspirin and beta-blocker use is optimal, while ACE inhibitor and statin prescription rates need enhancement.
Background:
Coronary artery disease is the leading cause of death in Kuwait, yet data about patient characteristics and practice patterns are lacking.
Objectives:
To establish a registry of all acute myocardial infarction (AMI) cases admitted to the general hospitals in Kuwait, so that the characteristics and management patterns of patients with AMI could be accurately determined.
Methods:
For six consecutive months, all patients with AMI admitted to the coronary care units of the five participating hospitals were prospectively included in the registry.
Results:
Of the 662 patients, 87% were men. The mean age was 55 years. A history of diabetes, hypertension and current smoking was found in 41%, 35% and 49% of patients, respectively. A history of hypercholesterolemia or a fasting cholesterol of 5.2 mmol/L or greater was found in 56% of patients. Eighty per cent suffered ST-segment elevation AMI. Four hundred seventy-six patients who were eligible for thrombolytic therapy were identified, 12 (3%) of whom did not receive it. The median time from diagnostic electrocardiogram to thrombolytic therapy was 45 min. The rate of prescribing acetylsalicylic acid, beta-blockers, angiotensin-converting enzyme inhibitors and statins at discharge among survivors was 98%, 86%, 51% and 50%, respectively. The in-hospital mortality rate was 6.2%.
Conclusions:
The Kuwaiti AMI population is young, with high rates of diabetes, smoking and hypercholesterolemia. The majority of patients have ST-segment elevation AMI. Thrombolytic therapy is appropriately used, but measures need to be introduced to decrease the time to treatment. The rate of use of acetylsalicylic acid and beta-blockers was appropriate, while that of angiotensin-converting enzyme inhibitors and statins needs to be improved.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Acute Coronary Syndrome I: Introduction
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:22Acute Kidney Injury I: Introduction