Background: The factors associated with mortality following acute coronary syndrome (ACS) based on patient satisfaction are unknown. The objective was to describe and compare factors associated with 1-year mortality following ACS according to high versus low patient satisfaction with hospital stay, doctors, and nurses. Materials and Methods: In a registry of 3565 patients presenting with ACS to 29 hospitals across 4 countries, we grouped patients by self-reported satisfaction with hospital stay reported at 1-month following ACS. The primary outcome was all-cause 1-year mortality following ACS, excluding patients with mortality before the initial 30-day follow-up. We examined associations of patient and hospitalization factors with risk of 1-year all-cause mortality in logistic regression models, unadjusted and adjusted for Global Registry of Acute Coronary Event (GRACE) risk score, reported as odds ratio (OR; 95% confidence interval). Results: In models adjusting for GRACE risk score, in the low satisfaction category, women, compared with men, had statistically similar odds of mortality (adjusted OR: 1.43 [0.99–2.04]). Lack of formal education (vs. any education) was associated with higher odds of mortality in the low satisfaction (aOR: 1.99 [1.33–3.04]; P < 0.01) and high satisfaction (aOR: 3.06 [1.93–5.00]; P < 0.001) categories (Pinteraction = 0.30). Lack of employment (vs. employment) was associated with similar higher odds of mortality in the low satisfaction (aOR: 6.37 [2.83–18.25]; P < 0.001) and high satisfaction (aOR: 2.58 [1.40–5.21]; P < 0.01) categories (Pinteraction = 0.08). Generally comparable results were obtained when analyzed by patient satisfaction with doctors and with nurses. Conclusions: Education and employment were major factors associated with higher 1-year mortality following ACS, independent of patient satisfaction, and may inform tailored educational and outreach interventions to reduce mortality.
We present the case of a 6-month-old male infant with a ventricular septal defect, in whom cardiac computed tomography revealed a rare association of a circumflex left aortic arch with bilateral brachiocephalic trunks. Recognition of this unusual arch configuration is crucial as it has significant implications for surgical planning.
Background: Diabetes mellitus (DM) is a major modifiable risk factor for coronary artery disease, and cardiovascular events can represent the first clinical manifestation of undiagnosed DM. Our study aims to determine the incidence of newly detected cardiovascular risk factors, including DM, prediabetes, dyslipidemia, hypertension, and smoking, among patients presenting with acute coronary syndrome (ACS) in Qatar. Methods: This cross-sectional observational study was included all patients admitted with ST-or non-ST-elevation myocardial infarction (MI) to Heart Hospital, Qatar, between March 1, 2015, and December 31, 2020. Data were extracted from electronic records, including newly diagnosed DM was defined as hemoglobin A1c (HbA1c) ≥6.5%; prediabetes as HbA1c 5.6%–6.4%; dyslipidemia as low-density lipoprotein (LDL) ≥3.3 mmol/L; and familial hyperlipidemia as LDL ≥4.9 mmol/L with a family history. Smoking and hypertension were also recorded. Results: Among 10,450 patients, the mean age of ACS was 51 ± 11 years, and 92.4% were male, 13.2% had newly diagnosed DM, and 21.2% met prediabetes criteria. Dyslipidemia, hypertension, and smoking were newly identified in 30.3%, 38.9%, and 27.3%, respectively. These findings suggest that ACS onset occurred at a markedly younger age compared to international cohorts. Conclusions: Undiagnosed cardiovascular risk factors, particularly DM and prediabetes, are highly prevalent and may be associated with earlier MI. Thus, early screening and preventive strategies should be more targeted and tailored to reflect the distinct cardiometabolic risk profiles of Middle Eastern populations.
We report a 3-year-old boy presenting with exertional dyspnea, where computed tomography revealed left brachiocephalic vein with two distinct anomalous posterior mediastinal pathways. Recognition of these rare systemic venous anomalies is essential for surgical planning and to avoid procedural complications.
Tricuspid regurgitation (TR) is a prevalent condition historically associated with high mortality and underrecognition. While medical therapy remains common, standalone surgical interventions involve significant perioperative risks. This has led to the emergence of transcatheter tricuspid valve interventions (TTVI) as a vital alternative for high-risk patients. Initiated and led by the Gulf Interventional Society, a multidisciplinary panel of experts was brought together to develop the current evidence and formulate a regional consensus and evidence-based recommendations for the management of tricuspid valve regurgitation in the Gulf region. TR is classified into primary (10%) and secondary (90%) types, with secondary TR further divided into atrial and ventricular subtypes. Evaluation relies on multimodality imaging, with echocardiography as the cornerstone and cardiac magnetic resonance for right ventricular assessment. While medical therapy focuses on decongestion, it does not modify TR progression. Surgical repair remains the gold standard for low-to-intermediate risk patients, but early referral is critical to avoid futile procedures in advanced disease. TTVI options, including edge-to-edge repair and replacement, are expanding in the Gulf, though regional adoption is hampered by fragmented healthcare systems and late presentations. Effective TR management in the Gulf requires a transition toward patient-centered care, early identification by primary care physicians, and a multidisciplinary “Heart Team” approach. Integrating digital health tools and establishing regional registries are essential to improving clinical outcomes and survival.
