Areca nut chewing and the risk of re-hospitalization and mortality among patients with acute coronary syndrome in Pakistan

Karim, M. T., Inam, S., Ashraf, T., Shah, N., Adil, S. O. and Shafique, K. (2018) Areca nut chewing and the risk of re-hospitalization and mortality among patients with acute coronary syndrome in Pakistan. Journal of Preventive Medicine and Public Health, 51(2), pp. 71-82. (doi: 10.3961/jpmph.17.189) (PMID:29631348) (PMCID:PMC5897234)

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Abstract

Objectives: Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Shafique, Dr Kashif
Authors: Karim, M. T., Inam, S., Ashraf, T., Shah, N., Adil, S. O., and Shafique, K.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:Journal of Preventive Medicine and Public Health
Publisher:Korean Society for Preventive Medicine
ISSN:1975-8375
ISSN (Online):2233-4521
Published Online:19 February 2018
Copyright Holders:Copyright © 2018 The Korean Society for Preventive Medicine
First Published:First published in Journal of Preventive Medicine and Public Health 51(2):71-82
Publisher Policy:Reproduced under a Creative Commons License

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