Risk factors, clinical features and outcome of acute myocardial infarction in Sana′a, Yemen

Abstract

Of all patients, 348 (90.2%) were men with a mean (+/- SD) age 54 +/- 11 years (range, 27-82 years) and 38 (9.8%) were women with a mean age of 59 +/- 11 years (range, 38-80 years). Almost all patients (97.9%) were Yemeni. The prevalence of risk factors was as follows: khat chewing (88%), smoking (81%), total serum cholesterol (29%), diabetes mellitus (25%) and hypertension (18%). When classified according to site, recurrence and severity of AMI, in 57.0% there was an anterior infarction, in 35.2% an inferior infarction,in 7.0% an inferoseptal infarction, in 1.8% a lateral infarction and location was undetermined in 2.5%. Only 34 (8.8%) patients had a previous history of AMI; in 352 (91.2%) patients, it was the first AMI. In 341 (88.3%) it was a Q-wave infarction while a non Q-wave infarction was found in 35 (9.1%) and in 10 (2.6%) it was undetermined. The complications of AMI were heart failure in 94 cases (24.6%), primary ventricular fibrillation or tachycardia in 18 cases (4.7%), and second or third degree atrioventricular block in 17 (4.4%). The ICU mortality rate was 11.4% (44 patients) and the total in-hospital mortality was 14.2% (55 patients). Causes of death during hospitalization were cardiogenic shock (62%), sudden death (18%), resistant arrhythmia (13%), brain embolization (5%), and hypoxic brain damage after CPR (2%).