title: Atrial fibrillation in Middle Eastern Arab and South Asian patients hospitalized with acute myocardial infarction: experience from a 20-year registry in qatar (1991-2010).
abstract: BACKGROUND
  Recent evidence suggests that there are ethnic variations in atrial fibrillation (AF) susceptibility and incidence following acute myocardial infarction (AMI).
  
  
  OBJECTIVE
  The aim of this study was to evaluate the incidence and predictors of AF in the setting of AMI in Middle Eastern Arab and South Asian patients and its impact on in-hospital morbidity and mortality.
  
  
  METHODS
  A retrospective analysis of a prospective registry of all patients hospitalized with AMI in the state of Qatar from 1991 through 2010 was made. Clinical characteristics and outcomes of AMI patients with and without AF were compared. Sub-analysis according to ethnicity was also performed.
  
  
  RESULTS
  During the 20-year period; a total of 12,881 patients were hospitalized with AMI. Of these 5028 were Arabs and 5985 were South Asians. A total of 227 had AF during hospitalization with an overall incidence of 1.8% (156 Arabs; incidence 3.1% and 48 South Asians; incidence 0.8%). The mean age of AF patients was 65 years (Arabs 69, South Asians 54). Patients with AF were significantly older and had more cardiovascular co-morbidities than patients without AF, and were more likely to have non-ST elevation AMI on presentation. Patients with AF had significantly higher in-hospital mortality rate (20.3% versus 7.1%; P=0.001) and stroke rates (1.8% versus 0.3%; P=0.001) when compared to patients without AF. Age was the only independent predictor of AF development in patients with AMI in our study.
  
  
  CONCLUSIONS
  Our study reports variability in the prevalence of AF among AMI patients according to ethnicity using a 20-year registry from a Middle Eastern country. Advancing age was the major independent predictor of AF in our AMI patients. Further prospective studies are required evaluating optimal therapeutic approaches for these high-risk patients in order to reduce the high mortality observed.
authors.affiliation: Dept. of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation, Qatar.
authors.forename: Amar M
authors.initials: AM
authors.lastname: Salam
authors.forename: Binali Hajar A
authors.initials: BH
authors.lastname: Al
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.forename: Abdurrazzak
authors.initials: A
authors.lastname: Gehani
authors.forename: Nidal
authors.initials: N
authors.lastname: Asaad
authors.forename: Awad
authors.initials: A
authors.lastname: Al-Qahtani
authors.forename: Jassim Al
authors.initials: JA
authors.lastname: Suwaidi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D018912:Arabs; D001210:Asia, Southeastern / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000208:ethnology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000208:ethnology*; D015995:Prevalence; D011780:Qatar / Q000453:epidemiology