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ORIGINAL ARTICLE
Year : 2005  |  Volume : 6  |  Issue : 3  |  Page : 93-97

Pattern of acute myocardial infarction management at coronary care units in Sana'a, Yemen - A pilot study


1 Medical Department, Al-Thawra Hospital, Sana'a, Yemen
2 Medical Department, Al-Jomhori Hospital, Yemen
3 Cardiac unit, Military hospital, Sana'a, Yemen

Correspondence Address:
Al-Motarreb
Al-Thawra Hospital, PO Box 89, Sana.a
Yemen
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Source of Support: None, Conflict of Interest: None


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Background: Coronary artery disease is a major cause of death in the world. In Yemen acute myocardial infarction (AMI) has increased sharply in recent years due to change in lifestyle of Yemenis. Intensive care units are now available in the big cities. There is no report available to show the pattern of the acute myocardial infarction management including thrombolytic therapy in Yemen. Therefore, we conducted a multicentre study in Sana'a City to determine the in-hospital management of AMI patients, in-hospital morbidity and mortality and the feasibility of establishing a nation-wide and long duration registry in Yemen. Methods: A prospective study enrolled all patients who have been diagnosed as AMI and admitted to the intensive care units in three general hospitals in Sana'a City during the month of May 2000. A specialist filled the data collection form for each patient. Results: 44 patients were admitted with diagnosis of AMI. 86.4% (38 patients) were male and 13.6% (6 patients) were female. All of the patients were Yemenis with a mean age of 51 (-55 years). Compared to the other risk factors current smoking was high at 50% across all age group. History of previous AMI, diabetes, and hypertension, was 6.8%, 6.8% and 18.2% respectively. Two patients (4.5%) gave a history of hypercholesterolemia. Thrombolytic therapy was given to 16 patients (36.4%). These patients presented to hospital within 12 hours from the onset of the symptoms and had no contraindications to thrombolytic therapy. Cardiogenic shock occurred in 10 patients (22.7%), heart failure in 4 patients (9.1%), recurrent ischemia in 4 patients (9.1%) and re-infarction in one patient (2.3%). No stroke or major bleeding was recorded and the total In-hospital mortality rate was 9.1 Prescribing medications at discharge among survivors was 90.5% for aspirin, 72.1% for nitrates, 67.4% for ACE inhibitors, 37.2% for beta-blockers, 11.6% for diuretics, 4.7% for calcium channel blockers and 0% for lipid lowering drugs. Conclusion: The rates of diabetes, smoking, hypercholesterolemia and hypertension were high among our patients being 52.3%, 50%, 22.72% and 18.2% respectively. The use of thrombolytic therapy was not appropriate and need to be improved. The rate of use aspirin and nitrates were adequate while that of b-blockers, ACE inhibitors and lipid lowering drugs need improvement.


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