Post-myocardial Infarction Prognostic Factors and Mortality in the Gulf Region: A Systematic Review and Meta-analysis

Introduction: Cardiovascular disease is a leading cause of mortality in the Gulf region, with acute Myocardial Infarction (MI) being a critical contributor due to prevalent comorbidities, including diabetes, hypertension, and obesity. This systematic review and meta-analysis evaluate the prognostic factors impacting post-MI outcomes. Methods: This study conducted a systematic review and meta-analysis to identify risk factors influencing Myocardial Infarction (MI) outcomes in Saudi Arabia and Gulf countries. A comprehensive search of major databases between 2013 and 2024 included studies examining demographic and clinical predictors such as age, gender, and comorbidities. Eligible studies were screened following PRISMA guidelines. Adjusted odds ratios for mortality were pooled, and heterogeneity was assessed through Q and I² statistics. Bias and publication bias were evaluated using ROBINS-I and funnel plots, respectively. Analyses were performed to provide region-specific insights into MI prognosis and outcome predictors. Results: The findings reveal that gender, age, comorbidities, and biomarkers significantly influence mortality risks. Women presented higher mortality rates than men, attributed to older age and a heavier comorbidity burden. Ventricular arrhythmias and recurrent MI emerged as predictors of adverse in-hospital outcomes, including heart failure and cardiogenic shock. The pooled odds ratio for short-term mortality indicated over three times the mortality risk following MI, although long-term mortality findings lacked statistical significance. Discussion: The findings highlight the combined impact of demographic and clinical factors on MI outcomes in the Gulf region. The gender disparity reflects both biological and systemic influences. Conclusion: Tailored interventions, improved risk stratification, and targeted management strategies are needed to address the high-risk profiles and outcome disparities in Gulf MI patients.