OBJECTIVE
To evaluate the prevalence and significance of khat chewing in patients with acute
coronary syndrome (ACS).
PATIENTS AND METHODS
From January 29, 2007, through July 29, 2007, 8176 consecutive patients presenting
with ACS were enrolled in a prospective, multicenter study from 6 adjacent Middle
Eastern countries.
RESULTS
Of the 8176 study patients, 7242 (88.6%) were non-khat chewers, and 934 (11.4%) were
khat chewers, mainly of Yemeni origin. Khat chewers were older (57 vs 56 years; P=.01) and more likely to be men (85.7% vs 74.5%) compared with non-khat chewers. Non-khat
chewers were more likely to have diabetes mellitus, hypertension, dyslipidemia, obesity,
and prior history of coronary artery disease and revascularization. Cigarette smoking
was more prevalent in khat chewers, and they were more likely to present greater than
12 hours after onset of symptoms compared with non-khat chewers. At admission, khat
chewers had higher heart rate, Killip class, and Global Registry of Acute Coronary
Events risk scores. Khat chewers had a significantly higher risk of cardiogenic shock,
stroke, and mortality. After adjustment of baseline variables, khat chewing was an
independent risk factor for in-hospital mortality (odds ratio, 1.9; 95% confidence
interval, 1.3-2.7; P<.001) and stroke (odds ratio, 2.7; 95% confidence interval, 1.3-5.9; P=.01).
CONCLUSION
In this large cohort of patients with ACS, khat chewing was prevalent and was associated
with increased risk of stroke and death. In the context of increasing global migration,
a greater awareness of potential widespread practices is essential.
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Article Info
Footnotes
Gulf Registry of Acute Coronary Events, a Gulf Heart Association project, was financially supported by Sanofi-Aventis, Paris, France, and Qatar Telecommunications Co, Doha, Qatar.
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© 2010 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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- Khat Chewing: A Smokeless Gun?Mayo Clinic ProceedingsVol. 85Issue 11
- PreviewChewing the leaves of the plant Catha edulis (referred to as khat, African salad, bushman's tea) likely dates to times of antiquity and may predate the use of coffee.1 An early written description of khat appeared in Paris in 1697 when Barthelemy d'Herbelot de Molainville traveled to Yemen (translated): “[It] is made with a seed which is unknown to us, which has been forbidden by the doctors of the law in the province of Yemen…, where it originated. …because it is too strong, and affects the brain.”2 It was not until 1975 that United Nations laboratories first discovered the active ingredient of khat to be cathinone, an amphetamine-like substance that has sympathomimetic, euphoric, and mood-altering effects among other health consequences.
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