title: Regional variability in hospital mortality in patients hospitalized with ST-segment elevation myocardial infarction: findings from the Gulf Registry of Acute Coronary Events.
abstract: OBJECTIVE
  To study the short-term mortality from ST-segment elevation myocardial infarction (STEMI) in the Arabian Gulf region of the Middle East, and to examine whether these geographically and culturally related countries had similar or different outcomes.
  
  
  METHODS
  The Gulf Registry of Acute Coronary Events recruited consecutive acute coronary syndrome patients from six Middle Eastern countries over a 5-month period.
  
  
  RESULTS
  Of 6,706 patients recruited, 2,626 (39%) had STEMI, and a total of 165 patients died in hospital, with a crude mortality rate of 6.3%. However, mortality rates varied geographically between 10% in Yemen, 9.6% in Oman and 3.3% in the other countries. The unadjusted odds ratio of mortality for Yemen was 3.2 (95% CI: 2.2-4.7), and 3.1 (95% CI: 1.9-4.8) for Oman, compared to other Gulf countries. Even after adjusting for age and gender, the mortality remained significantly higher, almost double, in Oman and Yemen compared to other countries. This could be understood in the light of significant differences in a number of practice pattern variables such as reperfusion therapy, timely presentation and use of evidence-based medications.
  
  
  CONCLUSIONS
  We found significant variability in STEMI mortality among Gulf Arab countries and identified areas requiring further efforts to reduce excess mortality in the region.
authors: Faculty of Medicine, Health Sciences Centre, Kuwait University, Jabriya, Kuwait. lthalib@hsc.edu.kw
authors: Lukman
authors: L
authors: Thalib
authors: Mohammad
authors: M
authors: Zubaid
authors: Wafa
authors: W
authors: Rashed
authors: Wael
authors: W
authors: Almahmeed
authors: Jawad
authors: J
authors: Al-Lawati
authors: Kadhim
authors: K
authors: Sulaiman
authors: Ahmed
authors: A
authors: Al-Motarreb
authors: Haitham
authors: H
authors: Amin
authors: Jassim
authors: J
authors: Al Suwaidi
authors: Khalid F
authors: KF
authors: Alhabib
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D004562:Electrocardiography; D005260:Female; D005843:Geography; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality* / Q000628:therapy; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D055815:Young Adult