title: Prevalence and outcome of cigarette and waterpipe smoking among patients with acute coronary syndrome in six Middle-Eastern countries.
abstract: OBJECTIVE
  We evaluated the prevalence and effect of cigarette smoking (CS) and waterpipe (WP) smoking on patients with acute coronary syndrome (ACS) in six Middle-Eastern countries.
  
  
  METHODS
  Analysis of the Gulf Registry of Acute Coronary Events (Gulf RACE) survey, which included 6704 consecutive patients hospitalized with ACS, was made and patients were divided into four groups depending on whether they were smokers - cigarette-CS, waterpipe-WS, combined cigarette and waterpipe (CW) - or non-smokers (NS).
  
  
  RESULTS
  Overall 38% of patients were smokers; 4.4% of patients were waterpipe smokers (1.4% WS and 3% CW). When compared to the three smokers' groups, non-smokers were older. Overall, smokers had fewer cardiovascular risk factors when compared to NS. ST-segment elevation myocardial infarction was more common among nicotine smokers (CS 54.4%, WS 57.3%, 47.3% CW vs 30% NS, p = 0.001) while NS were more likely to have non-ST elevation ACS. Cigarette (and not waterpipe) smokers were more likely to present early and with typical symptoms when compared to NS and WS. Admission heart rate and blood pressures were higher in the non-smoker group and WS. Non-smokers and WS were also more likely to present with Killip class >1. After adjustment for baseline variables, smoking was not an independent predictor of adverse cardiac events.
  
  
  CONCLUSIONS
  Cigarette smoking is prevalent among Middle-Eastern patients presenting with acute coronary syndrome. Waterpipe smoking use is low; however it is relatively more frequent in women when compared to cigarette smoking. The current study underscores the need for further studies into the effects of different forms of nicotine smoking.
authors: Department of Cardiology, Hamad Medical Corporation, Qatar and Weill Cornell Medical College, Qatar. jalsuwaidi@hotmail.com
authors: Jassim
authors: J
authors: Al Suwaidi
authors: Mohammad
authors: M
authors: Zubaid
authors: Ayman A
authors: AA
authors: El-Menyar
authors: Rajivir
authors: R
authors: Singh
authors: Nidal
authors: N
authors: Asaad
authors: Kadhim
authors: K
authors: Sulaiman
authors: Wael
authors: W
authors: Al Mahmeed
authors: Sulaiman
authors: S
authors: Al-Shereiqi
authors: Moosa
authors: M
authors: Akbar
authors: Hajar A
authors: HA
authors: Al Binali
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005374:Filtration / Q000295:instrumentation; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D014026:Nicotiana; D014867:Water
chemical_list: D014867:Water