RESUMEN
Objective: rapid coronary revascularization after ACS with ST elevation acute myocardial infarction [STEMI] is a cornerstone in management. Yemen where no primary Percutaneous Coronary Intervention available, utilizing thrombolytic therapy is the main tool for coronary reperfusion. The major objective was to highlight the magnitude of ACS among Yemeni patients, predisposing risk factors to ACS, the rate of use of thrombolytic therapy, the morbidity and mortality among those patients
Methods: gulf Race I is a prospective, multinational, multicenter survey of patients hospitalized with the final diagnosis of ACS in six Arabian Peninsula/Gulf countries over a period of six month
Results: 1054 Yemeni patients with ACS participated in the Gulf Race I, only 218 patients had received thrombolytic therapy out of 750 cases of STEMI or newly developed LBBB. Those 218 patients represent only 41% of all the cases [531 cases] eligible for thrombolytic therapy. The mean age 55.9 +/- 11.01 years and were mainly males. Streptokinase was commonly thrombolytic used [95.4%]. Smoking reported in 127 patient [58.3%], khat chewing in 163 patient [74.3%] while arterial hypertension in 57 cases [26.1%] and diabetes mellitus type II in 54 patients [24.8%]. The mean door to needle in those patient was 59.1 minutes. Heart failure in ACS group after thrombolytic therapy was reported in 11.5% of the patients and death in 14 patients 6.4%
Conclusions: ACS among Yemeni is one of the highest in the area, in spite of low rate of using thrombolytic therapy as a first line of revascularization in Yemen, still the time of presentation of the patient with ACS to the hospitals is late. Missing the golden hours for thrombolytic therapy in Yemeni patients with ACS is associated with high rate of morbidity and mortality. Community and physician awareness programs are needed for better management of ACS