Prediction of Major Adverse Cardiovascular Events Among Yemeni Patients with Acute Coronary Syndrome: A Comparative Study by Gender

Abstract

Background: Acute coronary syndrome (ACS) poses a significant burden in low- and middle-income countries like Yemen, where delays in care and limited resources elevate the risk of adverse outcomes. Identifying the predictors of in-hospital major adverse cardiovascular events (MACEs) is essential for improving management strategies.

Objective: To assess and compare the predictors of in-hospital MACEs among Yemeni patients diagnosed with ACS, with a specific focus on gender-based differences.

Methods: An observational, retrospective study included 1,743 Yemeni patients aged ≥18 years, admitted with ACS to six tertiary hospitals in Sana’a City between January 2020 and December 2023. The primary outcome was in-hospital MACEs including cardiac death, recurrent MI, or revascularization.

Results: MACEs occurred in 12.7% of patients, with a higher occurrence in females (16.5%) and STEMI cases (15.1%). The predictors included older age, STEMI, elevated blood sugar, WBC count, creatinine, low SBP, DBP, and HDL-c. Gender-specific predictors varied, with males showing associations with delayed presentation and prior PCI, and females showing associations with age, STEMI, and increased waist circumference.

Conclusion: Key predictors of MACEs were age, STEMI, elevated creatinine, and waist circumference, with notable gender-based differences suggesting the need for tailored interventions.