title: Mortality Trends in Patients Hospitalized with the Initial Acute Myocardial Infarction in a Middle Eastern Country over 20 Years.
abstract: We aimed to define the temporal trend in the initial Acute Myocardial Infarction (AMI) management and outcome during the last two decades in a Middle Eastern country. A total of 10,915 patients were admitted with initial AMI with mean age of 53 ± 11.8 years. Comparing the two decades (1991-2000) to (2001-2010), the use of antiplatelet drugs increased from 84% to 95%, β -blockers increased from 38% to 56%, and angiotensin converting enzyme inhibitors (ACEI) increased from 12% to 36% (P < 0.001 for all). The rates of PCI increased from 2.5% to 14.6% and thrombolytic therapy decreased from 71% to 65% (P < 0.001 for all). While the rate of hospitalization with Initial MI increased from 34% to 66%, and the average length of hospital stay decreased from 6.4 ± 3 to 4.6 ± 3, all hospital outcomes parameters improved significantly including a 39% reduction in in-hospital Mortality. Multivariate logistic regression analysis showed that higher utilization of antiplatelet drugs, β -blockers, and ACEI were the main contributors to better hospital outcomes. Over the study period, there was a significant increase in the hospitalization rate in patients presenting with initial AMI. Evidence-based medical therapies appear to be associated with a substantial improvement in outcome and in-hospital mortality.
authors.affiliation: Department of Adult Cardiology and Cardiovascular Surgery, Heart Hospital, P.O. Box 3050, Doha, Qatar ; Department of Cardiology, National Heart Institute, Cairo, Egypt.
authors.forename: Emad
authors.initials: E
authors.lastname: Ahmed
authors.affiliation: Department of Adult Cardiology and Cardiovascular Surgery, Heart Hospital, P.O. Box 3050, Doha, Qatar.
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
authors.affiliation: Department of Clinical Medicine, Weill Cornell Medical School, P.O. Box 24144, Doha, Qatar ; Clinical Research, Trauma Section, Hamad Medical Corporation (HMC), P.O. Box 3050, Doha, Qatar ; Internal Medicine, Cardiology Section, Ahmed Maher Teaching Hospital, Egypt.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: Department of Adult Cardiology and Cardiovascular Surgery, Heart Hospital, P.O. Box 3050, Doha, Qatar.
authors.forename: Hajar A H
authors.initials: HA
authors.lastname: AlBinali
authors.affiliation: Department of Adult Cardiology and Cardiovascular Surgery, Heart Hospital, P.O. Box 3050, Doha, Qatar.
authors.forename: Rajvir
authors.identifier: 0000-0003-2756-3164
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Adult Cardiology and Cardiovascular Surgery, Heart Hospital, P.O. Box 3050, Doha, Qatar ; Department of Clinical Medicine, Weill Cornell Medical School, P.O. Box 24144, Doha, Qatar.
authors.forename: A A
authors.initials: AA
authors.lastname: Gehani