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Khat chewing and cardiovascular risk profile in a cohort of Yemeni patients with angiographically documented coronary artery disease

Dec 6, 2012 7:00:00 PM / by Martin Witiak

Heart Asia, 12/07/2012

Shujaa AK et al. – The authors sought to explore the prevalence of khat chewing and cardiovascular risk profile in a cohort of Yemeni patients with angiographically documented coronary artery disease (CAD). In Yemeni patients undergoing elective coronary angiography, khat use was highly prevalent, whereas several classic risk factors were relatively infrequent. None of the risk factors or khat use differed substantially with the extent of CAD.

Dr Wail Nammas (12/10/2012) comments:

It is estimated that 20,000,000 people are using khat worldwide [1]. The problem of khat is not rare in Western countries. It was reported that 7 metric tons of khat pass through the Heathrow airport in London weekly [2]. In the United States, East African and Yemeni independent dealers are distributing khat [3]. In order to preserve its efficacy for a longer period of time, several synthetic forms were developed, including hagigat, mephedrone, and graba. Hagigat (capsules containing 200 mg of cathinone) is labeled as a natural stimulant in Israel [4]. Cathinone, the prime active substance in khat, acts as an indirect sympathomimetic alkaloid inducing the release of catecholamines from central dopaminergic and serotonergic synapses, as well as from peripheral norepinephrine storage sites [5-7]. Khat use was reported an independent risk factor for myocardial infarction [8]. Khat users presenting with acute coronary syndrome had worse in-hospital and one-year outcome, as compared with non-users [9].
We sought to explore any possible relationship between khat use and the extent of coronary artery disease (CAD) - in terms of the number of vessels affected by significant coronary stenosis (?50%) - in stable patients undergoing elective coronary angiography. We enrolled 100 consecutive Yemeni patients who underwent elective coronary catheterization. Patients were classified into 2 groups: khat users and non-users, and were assigned according to the number of affected coronary arteries as having single-vessel, two-vessel, or multi-vessel disease. The distribution of single- two-vessel and multi-vessel disease was matched between the two groups (p >0.05). We concluded that in patients with stable angina pectoris undergoing elective coronary angiography, the extent of CAD was matched between khat users and non-users.
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8. Al-Motarreb A, Briancon S, Al-Jaber N, et al. Khat chewing is a risk factor for acute myocardial infarction: a case-control study. Br J Clin Pharmacol. 2005;59:574-81.
9. Ali WM, Al Habib KF, Al-Motarreb A, et al. Acute coronary syndrome and khat herbal amphetamine use: an observational report. Circulation. 2011;124:2681-9.

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