Incidence of and Risk Factors for Recurrent Cardiovascular Disease Events in Middle-Eastern Adults

Abstract Background Individuals with established cardiovascular disease (CVD) are at a much higher risk of either recurrent cardiovascular events or death. Previous research has shown that the incidence rate for recurrent CVD events varies across countries and populations. The association of traditional CVD risk factors, such as age, smoking, hypertension and diabetes mellitus increases the risk of recurrent CVD events or death particularly in individuals with a history of cardiovascular disease (CVD). The United Arab Emirates (UAE) has one of the highest age-standardized death rate for CVD worldwide. The aim of our study was to estimate the incidence rates and determine the predictors of recurrent CVD events among UAE nationals. Methods We investigated an outpatient-based cohort of patients with a history of prior CVD visiting Tawam Hospital between January 1, 2008 and December 31, 2008 and followed-up until the end of study period, July 31, 2018. Univariable and multivariable-adjusted Cox proportional hazard regression models were used to explore the association between different major CVD risk factors and the risk of recurrent CVD. Results A total of 216 patients (167 males, 49 females) with a history of CVD were included in our study. They were followed for a median of 8.1 years (interquartile range 5.5 to 9.3 years), with a total of 1184 patient-years of follow-up. The overall incidence rate of recurrent CVD events was 92.1 per 1000 patient-years. The 8-year cumulative incidence was 73.7%. Age, female sex, and diabetes mellitus were significant predictors of recurrent CVD events. Females had an 85% higher probability of recurrent CVD than males. Conclusion The overall incidence rate of recurrent CVD events in the UAE is 92.1 per 1000 patient-years and is one of the highest in Middle Eastern region. Primary and tertiary preventive measures are urgently needed in order to improve CVD morbidity and mortality and attempt to reverse the alarming rates of new and recurrent CVD events among UAE nationals. These interventions should comply with international guidelines for CVD management.