Abstrakt

Management of ST elevation myocardial infarction in three central governorate hospitals in Sana during 2019

Al-Gunaid Ahmad, Askar Faiza, Al-Aghbari Khaled

Background: Ischemic Heart Disease (IHD) is the leading cause of morbidity and mortality around the world and its prevalence is expected to continue to increase in developing countries due to increase its risk factors. Patient characteristics and practice patterns in developing regions of the World differ significantly from those of western countries. It’s imperative to investigate how patients in Yemen are present, being managed and how their outcomes compare with patients in neighbouring countries and in developed countries.

Objective: The aim of the study is to describe the presentations, characteristics, practice pattern of management and outcomes of patients hospitalized with ST-segment Elevation Myocardial Infarction (STEMI) in cardiac units of three central governorate hospitals in Sana’a during 2019. Methods and patients: Descriptive, retrospective, cross sectional study was designed for this study. Data was collected from cardiac units of three central, governorate hospitals in Sana’a during 2019. Special questionnaire was designed to record general characters, risk factors, management plan and out come during hospitalization.

Results: A total 329 patient’s files were met the inclusion criteria, 84.5% were males, the mean age ± SD was (55.09 ± 11.76) years, the median was 55 years, 86.9% were khat chewers and 83.6% were current and ex cigarette smoker. DM2 and HTN was 28.9% and 24.3%. Only 54.1% of total was arrived hospitals at first 12 h, with the median time was (4.5 h) 270 minutes. 41% of total (75.8% of eligible) underwent thrombolytic therapy whereas 3.65% of total (6.7% of eligible) re-perfused by PPCI. The prescribed medication at admission and discharge was according guideline of AHA and ECS. The final outcome 86.6% of total was improved.

Conclusion: The study showed that Yemeni STEMI patients present at a relatively young age and have high rates of khat chewing and smoking. STEMI patients delayed a long time before presenting to the hospital and less than half of them received TT and only few that received primary PCI within the recommended time line. In-hospital, guidelines based medication rates were high, but coronary investigation and revascularization rates were low. In hospital short term mortality was relatively high, especially among patients who received conservative therapy.