Background: ST-elevation myocardial infarction (STEMI) complications are widespread and have a direct effect on the length of stay (LOS) and mortality of patients. Reperfusion therapy via Percutaneous Coronary Intervention mainly impacts outcomes within the first few hours. Consequently, delaying this procedure is a key concern in STEMI management. The door-to-balloon (D2B) time is a crucial predictor of clinical outcomes. This study investigates whether D2B time can predict post-STEMI complications and length of hospital stay, accounting for sociodemographic and clinical variables. Methods: This prospective observational study involved 536 patients with confirmed STEMI, recruited consecutively from 8 hospitals in Amman, Jordan. Patients were classified as delayed if their D2B time was ≥2 h. Logistic regression analyzed the impact of delay on complications, while multiple regression assessed how delay time affected LoS. Results: The median D2B time was 108 min (IQR 65–395). The delayed group and patients with a previous AMI had 2.22- and 1.41-times higher risks of complications, respectively, compared to their counterparts. Patients with a history of HTN and DM faced 1.24- and 1.18-times higher risks of complications versus their respective groups. Each additional hour of door-to-balloon delay was associated with an increase of 0.294 days in hospital length of stay. Conclusions: D2B ≥ 2 h is linked to increased complications and longer LoS. Timely management can reduce complications, shorten LoS, and lower hospital resource use.

Background/Objectives: Telehealth has promising opportunities for hypertension management through remote monitoring and enhanced patient–provider communication. However, the usability of these services may vary across patient populations, particularly with respect to age and clinical complexity. This study examined the association of age and specific comorbidity categories with perceived telehealth usability among patients with hypertension in Saudi Arabia. Methods: An analytical cross-sectional study using questionnaire data linked with retrospective electronic health-record information was conducted among adults with physician-diagnosed hypertension who received telehealth follow-up following hospital discharge. Participants completed the Arabic version of the Telehealth Usability Questionnaire (TUQ). Sociodemographic and clinical data were extracted from electronic health records. Age in years was entered as a continuous variable in the primary multivariable model, while age group was examined as a categorical sensitivity analysis. Comorbidity was entered as a nominal categorical variable using hypertension only/no additional comorbidity as the reference group. Because group variances were heterogeneous, Welch’s ANOVA and Games–Howell post-hoc comparisons were used for group comparisons. Results: We included 266 adults with physician-diagnosed hypertension. Mean age among the 265 participants with valid age entries was 48.38 years (SD 18.80), and 56.0% were female. The mean total TUQ score was 93.11 ± 21.58, corresponding to a mean item score of 4.43 ± 1.03. According to the prespecified mean-item scoring framework, this represented moderate perceived usability. Significant differences were observed across age groups (Welch’s F(5,46.07) = 8.96, p < 0.001; η² ≈ 0.177), with the highest mean TUQ score among participants aged 20–30 years (110.75 ± 31.72) and the lowest among those aged >70 years (82.53 ± 7.33). In the corrected multivariable model, age was inversely associated with the TUQ score (B = −0.357, 95% CI −0.525 to −0.190; p < 0.001; β = −0.314). Compared with hypertension only/no additional comorbidity, the “other comorbidities” group had higher TUQ scores (B = 23.292, 95% CI 12.392–34.192; p < 0.001), whereas diabetes, chronic kidney disease, and respiratory conditions were not independently associated with the TUQ score. Conclusions: Perceived telehealth usability among patients with hypertension varied according to age and specific clinical characteristics. Older age was associated with less favorable usability perceptions, whereas the pattern across comorbidity categories was heterogeneous rather than uniformly positive or negative. These findings support age-sensitive, patient-centered telehealth design and targeted usability support for clinical subgroups experiencing greater barriers to digital care.

Background: Premature atherosclerotic cardiovascular disease (ASCVD) represents a growing clinical and public health concern, particularly in regions with a high burden of modifiable risk factors. Whether premature ASCVD reflects a distinct pathophysiological entity or an earlier manifestation of shared risk exposures remains incompletely understood. This study aimed to characterize the clinical profile of premature ASCVD and to examine its relationship with conventional cardiovascular risk factors within a Middle Eastern cohort. Methods: This pooled observational analysis included 2763 adults with established ASCVD derived from multiple cardiovascular registries and a prospective cohort. Premature ASCVD was defined using sex-specific age thresholds (<55 years in men and <65 years in women). Multivariable logistic regression analyses, including sex-stratified models, were performed to evaluate associations between premature presentation and cardiovascular risk factors, including smoking, family history, lipid parameters, and cardiometabolic comorbidities. Results: Among 2763 participants in the pooled clinical cohort, 1335 (48.3%) met the study definition of premature ASCVD. Compared with later-onset disease, premature ASCVD was strongly associated with current smoking, family history of premature cardiovascular disease, and a more atherogenic lipid profile, including higher levels of low-density lipoprotein cholesterol, triglycerides, and non-high-density lipoprotein cholesterol. In contrast, later-onset ASCVD was characterized by a higher prevalence of hypertension and diabetes mellitus. These patterns were consistent across sex-stratified analyses. Despite high rates of secondary prevention therapy use, a substantial residual atherogenic burden was observed among patients with premature ASCVD. Conclusions: In this predominantly coronary cohort, the findings suggest that premature and later-onset ASCVD occur within a broadly overlapping risk-factor landscape, but that the relative distribution of these factors differs according to age at first clinical presentation. The greater prevalence of smoking, family history, and atherogenic lipid abnormalities among younger patients may reflect earlier or greater exposure to these factors, whereas the greater burden of hypertension, diabetes mellitus, and other chronic comorbidities among older patients is consistent with their progressive accumulation with age. These cross-sectional associations should not be interpreted as demonstrating distinct causal mechanisms or age-independent risk profiles.