Abstract
Background: One third of all deaths worldwide are attributed to acute coronary syndrome. The thrombolysis in Myocardial Infarction Risk Score is used to assess the risk of mortality and major adverse outcomes in this population. This study aimed to assess and compare the morbidity and mortality differences rate between Saudi and non-Saudi patients with acute coronary syndrome.
 Methods: This retrospective study was conducted at the coronary care unit of King Abdulaziz University Hospital. All acute coronary syndrome cases were enrolled and assessed using the thrombolysis in Myocardial Infarction Risk Score.
 Results: 242 cases were divided as 98 ST-elevation myocardial infarction cases and 144 unstable angina/non ST-elevation myocardial infarction. Among ST-elevation myocardial infarction patients 21 were Saudi patients and 77 were non-Saudi patients with the median thrombolysis in myocardial infarction risk score for Saudi was 5 and for non-Saudi 3.5 (P = 0.6). Unstable angina/non ST-elevation myocardial infarction cases had 47 Saudi patients and 94 non-Saudi patients with the median score was 4.2 for Saudis versus 4.5 for non-Saudis (P = 0.4).
 Conclusion: Overall thrombolysis in myocardial infarction were higher in Saudis with ST-elevation myocardial infarction than non-Saudis, and higher for non-Saudis with unstable angina/non ST-elevation myocardial infarction than Saudis. However, the difference was not significant (p = 0.6, p = 0.4). The 30 days and one-year mortality as well as major adverse cardiac events were similar between the two groups in ST-elevation myocardial infarction (P = 0.4 and 0.7) and unstable angina/non ST-elevation myocardial infarction population (P = 0.3 and 0.3).
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