Prevalence of coronary artery disease and its risk factors in Majmaah City, Kingdom of Saudi Arabia

ObjectiveThis study was carried out with an aim to outline the prevalence of coronary artery diseases, its risk of one region of the Saudi Arabia.MethodsA retrospective observational study conducted across five secondary medical centers located in the city of Majmaah. Hospital medical records and ministry of health records were screened over a 6-month period for data on patients admitted for Coronary artery disease (CAD). Data collected included sociodemographic characteristics, medical profile, and laboratory findings.ResultsA total of 327 participants were included in this study with a median age of 64 and the majority being male participants (59.8%). The majority were married, held a primary school degree and earned a salary for living. A large number (82.9%) were hypertensive and diabetic (66.7%) and one-fourth had a previous MI (25.1%). A large number (73.7%) had heart failure with a mean ejection fraction of 44% (SD = 13). The causes of heart failure were mainly ischemic (56.3%) and hypertensive (28.1%). Readmission rates at 30 and 90 days then at 6 and 12 months were 22, 53.8, 68.8, and 75.8%, respectively. The mortality rates at the same time intervals were 5.5, 8.9, 14.1, and 22.9%, respectively. Predictors of readmission are age, CCI, and NYHA class.ConclusionCoronary artery disease is the leading cause of heart failure. End stage CAD can have similar results in terms of readmission and mortality as heart failure. Future research should target patients in different stages of the condition and monitor their comorbidities which may impact the study findings

Not to be Overlooked: The Need for Increased Dialogue Between Patient and Provider Surrounding Medical Foods in IBD

Background Medical foods are treatments with growing evidence for use in a variety of gastrointestinal diseases. They are safe and have proven efficacy in helping to manage inflammatory bowel disease (IBD). They can be used as monotherapy or in addition to traditional therapies. While medical foods offer new, evidence-based options to treat IBD, physician awareness of them remains uncertain. We examined the frequency with which gastroenterologists discussed their use for IBD management and explored associations with gender or race. Methods A retrospective review of all IBD patients seen at an urban university gastroenterology practice in a 6-month period was performed. There were no exclusion factors. Patient age, gender, ethnicity, and disease type were obtained. Records were evaluated for discussions about medical foods as IBD therapy. The associations between discussion of medical foods and gender or race were analyzed with a Chi-square test. Results 268 records were reviewed. Of those, 118 were men and 150 were women, with a mean age of 43. 80 were Black, 143 White, 6 Latino, 10 Asian, and 29 other. 158 had a diagnosis of Crohn’s and 109 had ulcerative colitis (UC), while 1 had indeterminate colitis. 8 (3%) in the cohort had a documented discussion about using medical foods to treat IBD. 6 discussed VSL#3 (2 Crohn’s, 4 UC), while 2 discussed Ensure (2 Crohn’s). There was no association between discussion of medical foods and gender (P=0.3) or race (P=0.9). Conclusion Medical foods are emerging in IBD management, with new evidence supporting their use in a diversity of clinical settings. While previously unclear, our study demonstrates that few IBD patients have documented discussions about medical foods. Though some discussions about medical foods may be undocumented, that only 3% of patients had documented discussions suggests clinicians are missing an opportunity to utilize this therapeutic option. Given the growing evidence for therapeutic use of medical foods in IBD, physicians should increase the visibility of their use