Acute coronary syndrome and Khat consumption in Yemeni women admitted to Coronary Care and Intensive Care in major hospital in Yemen

الملخص

Background: There is a significant percent of normal coronaries in patients with a history of documented myocardial infarction among Yemeni patients who have undergone diagnostic coronary angiogram, and they theoretically attributed that to the effect of Khat as a vasoconstrictor to the coronary artery. Also, unadjusted comparisons of mortality and major morbidity after acute myocardial infarction have generally indicated that women have a poorer outcome than men.

Methods: Data was collected prospectively from 15 hospitals in 8 governorates with acute coronary syndrome registry in the Gulf countries. All female patients who were admitted in any monitored bed in Coronary Care Units (CCU) or Intensive Care Units (ICU) with a provisional diagnosis of acute coronary syndrome (ACS) were included in the study. The presentations with khat chewing were compared with all other known and documented risk factor outcomes among women using multiple logistic regressions.

Results There were 50.5% regular khat chewers of female patients at presentations to the general emergency department with an attack of acute coronary syndrome; 14.4% of all female patients have no other risk factors except khat. These patients were relatively younger and had a lower body mass index (BMI) when compared with the incidence of acute events in other populations. They had no significantly worse outcome during hospitalization in comparison to the males of the same age group.

Conclusions It seems likely that there is at most only an intermediate association between Khat and the development of acute coronary syndrome in females, with less mortality and morbidity after suspected acute myocardial infarction. However, a larger study is needed, with more complete adjustment for coexisting risk factors, to determine whether the female has a worse outcome, which increases with khat.