Weekend Versus Weekday, Morning Versus Evening Admission in Relationship to Mortality in Acute Coronary Syndrome Patients in 6 Middle Eastern Countries: Results from Gulf Race 2 Registry

Jawad A Al-Lawati 1, Ibrahim Al-Zakwani*, 2, 3, Kadhim Sulaiman 4, Khalid Al-Habib 5, Jassim Al Suwaidi 6, Prashanth Panduranga 4, Alawi A Alsheikh-Ali 7, 8, Wael Almahmeed 7, Husam Al Faleh5, Shukri Al Saif 9, Ahmad Hersi 5, Nidal Asaad 6, 10, Ahmed Al-Motarreb 11, Dimitri P Mikhailidis 12, Haitham Amin 13
1 Department of Non-Communicable Diseases Surveillance and Control, Ministry of Health, Muscat, Oman
2 Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
3 Gulf Health Research, Muscat, Oman
4 Department of Cardiology, Royal Hospital, Muscat, Oman
5 King Fahad Cardiac Centre, King Khalid University Hospital, College of Medicine, Riyadh, Saudi Arabia
6 Department of Cardiology, Hamad Medical Corporation (HMC), Doha, Qatar
7 Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
8 Tufts Clinical and Translational Science Institute and Tufts University School of Medicine, Boston, Massachusetts, USA
9 Saud Al Babtain Cardiac Center, Dammam, Saudi Arabia
10 Weill Cornell Medical School, Doha, Qatar
11 Faculty of Medicine, Sana’a University, Sana’a, Yemen
12 Department of Clinical Biochemistry, Royal Free Hospital, University College London Medical School, University College London, London, England, UK
13 Mohammed Bin Khalifa Cardiac Centre, Bahrain

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© Al-Lawati et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khodh, PC-123, Sultanate of Oman; Tel: +968-2414-4420; Fax: +968-2414-4430; E-mail:


We used prospective cohort data of patients with acute coronary syndrome (ACS) to compare their management on weekdays/mornings with weekends/nights, and the possible impact of this on 1-month and 1-year mortality. Analyses were evaluated using univariate and multivariate statistics. Of the 4,616 patients admitted to hospitals with ACS, 76% were on weekdays. There were no significant differences in 1-month (odds ratio (OR), 0.88; 95% CI: 0.68-1.14) and 1-year mortality (OR, 0.88; 95% CI: 0.70-1.10), respectively, between weekday and weekend admissions. Similarly, there were no significant differences in 1-month (OR, 0.92; 95% CI: 0.73-1.15) and 1-year mortality (OR, 0.98; 95% CI: 0.80-1.20), respectively, between nights and day admissions. In conclusion, apart from lower utilization of angiography (P < .001) at weekends, there were largely no significant discrepancies in the management and care of patients admitted with ACS on weekdays and during morning hours compared with patients admitted on weekends and night hours, and the overall 30-day and 1-year mortality was similar between both the cohorts.

Keywords: Acute coronary syndrome, Weekend, Weekday, Mortality, Admission. .