Table 1.
Patient baseline characteristics, procedures, and outcomes in the study.
| Variable | n (%) | STEMI/New LBBB n (%) |
NSTEACS n (%) |
P value |
|---|---|---|---|---|
|
| ||||
| Demographics | ||||
| Age, mean (SD), years | 56 (17) | 54 (16) | 58 (17) | <.001 |
| Male, n (%) | 6253 (78.8) | 3119 (86.1) | 3134 (72.6) | <.001 |
| Arabian Gulf citizen, n (%) | 5674 (71.2) | 2366 (65.3) | 3308 (76.6) | <.001 |
| Body mass index, mean (SD), kg/m2a | 26.2 (5.8) | 25.8 (5.5) | 26.7 (6.2) | <.001 |
| Central obesity, n (%)b | 2196 (50.1) | 1057 (45.5) | 1139 (55.4) | <.001 |
| Ambulance use, n (%)c | 1325 (19.1) | 621 (19.8) | 704 (18.5) | .195 |
| Initial presentation | ||||
| Typical ischemic chest pain, n (%) | 6675 (84.1) | 3244 (89.6) | 3431 (79.5) | <.001 |
| Cardiac arrest | 47 (0.59) | 28 (0.77) | 19 (0.44) | <.001 |
| SBP, mean (SD), mm Hg | 132 (35) | 130 (40) | 138 (36) | <.001 |
| DBP, mean (SD), mm Hg | 80 (20) | 80 (20) | 80 (20) | .164 |
| HR, mean (SD), bpm | 82 (25) | 84 (26) | 81 (24) | .339 |
| Atrial fibrillation, n (%) | 166 (2.1) | 43 (1.2) | 123 (2.8) | <.001 |
| Killip class >1, n (%) | 1822 (23) | 765 (21.1) | 1057 (24.5) | <.001 |
| History | ||||
| CAD, n (%) | 4548 (57.3) | 1110 (30.6) | 3438 (79.6) | <.001 |
| PCI, n (%) | 727 (9.2) | 128 (3.5) | 599 (13.9) | <.001 |
| CABG, n (%) | 336 (4.2) | 36 (1) | 300 (6.9) | <.001 |
| CHF, n (%) | 523 (6.6) | 71 (2) | 452 (10.5) | <.001 |
| CVA/TIA, n (%) | 341 (4.3) | 118 (3.3) | 223 (5.2) | <.001 |
| PAD, n (%) | 145 (1.8) | 39 (1.1) | 106 (2.5) | <.001 |
| CRF, n (%) | 319 (4) | 43 (1.2) | 276 (6.4) | <.001 |
| Diabetes mellitus, n (%) | 3137 (39.5) | 1167 (32.2) | 1970 (45.6) | <.001 |
| Hypertension, n (%) | 3748 (47.2) | 1246 (34.4) | 2502 (58.0) | <.001 |
| Current smoking, n (%) | 2834 (35.7) | 1726 (47.6) | 1108 (25.7) | <.001 |
| Ex-smoking, d n (%) | 1363 (17.2) | 610 (16.8) | 753 (17.4) | <.001 |
| Khat chewing, n (%) | 1408 (18.4) | 983 (27.9) | 425 (10.3) | <.001 |
| Hyperlipidemia, n (%) | 2598 (32.7) | 750 (20.7) | 1848 (42.8) | <.001 |
| Laboratory findings | ||||
| Positive serum troponin, n (%)e | 5426 (68.4) | 3124 (86.5) | 2302 (53.3) | <.001 |
| Peak creatine kinase MB, ng/mLe | 49 (103) | 94 (152) | 18 (35) | <.001 |
| Total cholesterol, mmol/Le | 4.8 (1.9) | 5 (1.8) | 4.6 (1.9) | <.001 |
| Triglyceride, mmol/Le | 1.5 (1.1) | 1.6 (1.1) | 1.5 (1.1) | <.001 |
| High-density lipoprotein cholesterol, mmol/Le | 1 (0.4) | 1 (0.4) | 1 (0.4) | .042 |
| Low-density lipoprotein cholesterol, mmol/Le | 3.1 (1.6) | 3.3 (1.5) | 2.9 (1.5) | <.001 |
| Fasting serum glucose, mmol/Le | 6.3 (3.3) | 6.2 (3.3) | 6.3 (3.3) | .864 |
| HbA1c, %e | 7 (3.2) | 7 (3.6) | 7 (2.9) | .543 |
| Serum first creatinine, μmol/Lf | 88 (33.4) | 88 (30.8) | 86.3 (34.6) | <.001 |
| Serum pre-hospital discharge creatinine, μmol/Le | 88 (32) | 88 (29) | 88 (38) | .718 |
| GRACE score | ||||
| Low, n (%) | 3068 (39.2) | 1481 (41.8) | 1587 (37.1) | <.001 |
| Intermediate, n (%) | 3055 (39.0) | 1289 (36.4) | 1766 (41.3) | <.001 |
| High (%) | 1702 (21.8) | 774 (21.8) | 928 (21.7) | .884 |
| Procedures (at index hospitalization) | ||||
| Echocardiography, n (%) | 6073 (76.5) | 2881 (79.5) | 3192 (73.9) | <.001 |
| Mild LV dysfunction, n (%) | 2713 (44.7) | 1508 (52.4) | 1205 (37.8) | <.001 |
| Moderate LV dysfunction, n (%) | 1198 (19.7) | 688 (23.9) | 510 (16) | <.001 |
| Severe LV dysfunction, n (%) | 562 (9.3) | 240 (8.3) | 322 (10.1) | <.001 |
| Coronary angiography, n (%) | 2579 (32.5) | 979 (27) | 1600 (37.1) | <.001 |
| Left main disease, n (%) | 146 (5.6) | 37 (3.8) | 109 (6.8) | .001 |
| 1-vessel disease, n (%) | 762 (29.5) | 365 (37.3) | 397 (24.7) | <.001 |
| 2-vessel disease, n (%) | 626 (24.2) | 275 (28.1) | 351 (21.9) | <.001 |
| 3-vessel disease, n (%) | 771 (29.8) | 228 (23.3) | 543 (33.9) | <.001 |
| PCI, n (%)f | 1148 (21) | 456 (17.3) | 692 (24.4) | <.001 |
| CABG, n (%) | 233 (2.9) | 65 (1.8) | 168 (3.9) | <.001 |
| In-hospital outcomes | ||||
| Recurrent ischemia | 1233 (15.5) | 665 (18.4) | 568 (13.2) | <.001 |
| Recurrent MI | 172 (2.2) | 127 (3.5) | 45 (1) | <.001 |
| CHF | 1041 (13.1) | 516 (14.2) | 525 (12.2) | .006 |
| Cardiogenic shock | 458 (5.8) | 324 (8.9) | 134 (3.1) | <.001 |
| VT and/or VF | 225 (2.8) | 180 (5) | 45 (1) | <.001 |
| Nonsurgical ventilation | 370 (4.7) | 222 (6.1) | 148 (3.4) | <.001 |
| Stroke | 56 (0.7) | 40 (1.1) | 16 (0.4) | <.001 |
| Major bleeding | 47 (0.6) | 25 (0.7) | 22 (0.5) | .296 |
| Death | 362 (4.6) | 253 (7) | 109 (2.5) | <.001 |
| Median length of hospital stay, median (IQR), days | 5.0 (4.0) | 5.0 (4.0) | 4.0 (3.0) | <.001 |
| 30-day mortality | 572 (7.21) | 356 (9.85) | 216 (5) | <.001 |
| 1-year mortality | 749 (9.43) | 417 (11.51) | 332 (7.69) | <.001 |
| Total | 7930 | 3613 (45.6) | 4317 (54.4) | |
SD: Standard deviation; STEMI: ST-segment elevation myocardial infarction; LBBB: left bundle branch block; NSTEACS: non–ST-segment elevation myocardial infarction; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; bpm: beats per minute; CAD: coronary artery disease; PCI: percutaneous coronary intervention; CABG: coronary artery bypass graft surgery; CHF: congestive heart failure; CVA/TIA: cerebrovascular accident/transient ischemic attack; PAD: peripheral arterial disease; CRF: chronic renal failure; MI: myocardial infarction; VT: ventricular tachycardia; and VF: ventricular fibrillation; LV: left ventricular.
a
Unknown serum troponin in 796 (10%) patients.
b
Data were available for 4385 patients.
c
Data were available for 6940 patients.
d
Stopped smoking more than 1 year before index hospitalization.
e
Median (IQR).
f
Data were available for PCI in 5462 patients.