Document Detail

Acute coronary syndrome and khat herbal amphetamine use: an observational report.
MedLine Citation:
PMID:  22155995     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The khat plant is a stimulant similar to amphetamine and is thought to induce coronary artery spasm. Khat is widely chewed by individuals originating from the Horn of Africa and the Arabian Peninsula. The aim of this study was to evaluate the clinical characteristics and outcome of khat chewers presenting with acute coronary syndrome.
METHODS AND RESULTS: From October 1, 2008, through June, 30, 2009, 7399 consecutive patients with acute coronary syndrome were enrolled in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-2). Nineteen percent of patients were khat chewers; 81% were not. Khat chewers were older, more often male, and less likely to have cardiovascular risk factors. Khat chewers were less likely to have a history of coronary artery disease and more likely to present late and to have higher heart rate and advanced Killip class on admission. Khat chewers were more likely to present with ST-segment-elevation myocardial infarction. Overall, khat chewers had higher risk of death, recurrent myocardial ischemia, cardiogenic shock, ventricular arrhythmia, and stroke compared with non-khat chewers. After adjustment for baseline variability, khat chewing was found to be an independent risk factor of death and for recurrent ischemia, heart failure, and stroke.
CONCLUSIONS: Our data confirm earlier observations of worse in-hospital outcome among acute coronary syndrome patients who chew khat. This worse outcome persists up to 1 year from the index event. This observational report underscores the importance of improving education concerning the cardiovascular risks of khat chewing.
Waleed M Ali; K F Al Habib; Ahmed Al-Motarreb; Rajvir Singh; Ahmad Hersi; Hussam Al Faleh; Nidal Asaad; Shukri Al Saif; Wael Almahmeed; Kadhim Sulaiman; Haitham Amin; Jawad Al-Lawati; Nizar Al Bustani; Norah Q Al-Sagheer; Awad Al-Qahtani; Jassim Al Suwaidi
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  124     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  2012-02-07     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2681-9     Citation Subset:  AIM; IM    
Department of Cardiology, Hamad Medical Corp, Qatar.
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MeSH Terms
Acute Coronary Syndrome / epidemiology*,  ethnology,  mortality*
Amphetamine / adverse effects*
Catha / adverse effects*
Heart Failure / epidemiology,  mortality
Middle Aged
Middle East / epidemiology
Multivariate Analysis
Myocardial Ischemia / epidemiology,  mortality
Plant Preparations / adverse effects*
Prospective Studies
Retrospective Studies
Risk Factors
Stroke / epidemiology,  mortality
Survival Rate
Reg. No./Substance:
0/Plant Preparations; 300-62-9/Amphetamine
Comment In:
Circulation. 2012 Aug 7;126(6):e85; author reply e87-8   [PMID:  22869866 ]
Circulation. 2012 Aug 7;126(6):e84; author reply e87-8   [PMID:  22869865 ]
Circulation. 2012 Aug 7;126(6):e86; author reply e87-8   [PMID:  22869867 ]

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