Clinical Characteristics, Procedural Performance, and In-Hospital Outcomes of Primary Percutaneous Coronary Intervention among Yemeni Patients Presenting with ST-Segment Elevation Myocardial Infarction: A Prospective Observational Study

Abstract

Objective: To evaluate the clinical characteristics, angiographic findings, procedural performance, and in-hospital outcomes of Yemeni patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methodology: A prospective observational study was conducted at the Cardiac Center of Al-Thawra Modern General Hospital, Sana’a, Yemen, between November 2023 and April 2024. Consecutive adult patients diagnosed with STEMI and treated with primary PCI were enrolled. Demographic characteristics, cardiovascular risk factors, clinical presentation, laboratory findings, angiographic features, procedural outcomes, and in-hospital clinical outcomes were collected using standardized data collection forms. Results: A total of 160 patients underwent primary PCI during the study period. The mean age was 56 ± 9 years, and 80.6% of patients were male. Khat chewing was the most prevalent cardiovascular risk factor (86.9%), followed by tobacco use (74.4%) and diabetes mellitus (40.0%). The median symptom-to-door time was 300 minutes (IQR: 180–480), while the median door-to-balloon time was 180 minutes (IQR: 120–300). The left anterior descending artery was the most common culprit vessel (55.0%), and single-vessel disease was present in 63.8% of patients. Procedural success was achieved in 82.5% of cases, and significant post-procedural ST-segment resolution occurred in 71.3% of patients. In-hospital mortality was 7.5%, while major adverse cardiovascular events (MACE) occurred in 22.5% of patients. Cardiogenic shock, acute heart failure, and ventricular arrhythmias occurred in 4.4%, 4.4%, and 5.0% of patients, respectively. Conclusion: Primary PCI appears to be an effective reperfusion strategy for STEMI management in Yemen despite substantial healthcare system challenges. However, prolonged prehospital and in-hospital treatment delays remain common and may adversely influence clinical outcomes.