Call for Awareness: ST-Segment Elevation Myocardial Infarction Presentation is Delayed more than What We Expect

Authors

Owayed Al Shammeri^{1, *,} , Hala El-Saka², Bushra E. Al-Hutahly³, Alaa E. Abd Elmoniem^3,

¹Department of Cardiology, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia

²Department of Pathology, King Fahad Specialist Hospital, Qassim, Saudi Arabia

³Department of Medicine, Qassim University, Qassim, Saudi Arabia

^*Corresponding author. Email: oalhermas@yahoo.com

DOI

10.2991/dsahmj.k.201105.001How to use a DOI?

Keywords

Acute myocardial infarction; histopathology; thrombectomy

Abstract

Background: ST-Segment Elevation Myocardial Infarction (STEMI) therapy in Saudi Arabia may have particular limitations because of geographic limitations, human resource distribution, and lack of an effective first response system. The aim of this study is to investigate the effective age of STEMI in Saudi Arabia by focusing on the histopathology of extracted thrombus.

Methods: Details of 25 consecutive cases of STEMI patients who were treated with primary Percutaneous Coronary Intervention (PCI), including using suction thrombectomy, were analyzed using clinical, angiographic, and histopathological data. Based on histopathological findings supported by immunohistochemical study, we further classify the small cohort according to age and compare them with available data in the literature.

Results: Results showed that nine out of 25 patients had non-recent thrombus (36%), which suggests the age of STEMI of more than 24 h. In a literature review of histopathology studies on thrombus in STEMI, the rate of non-recent thrombus in STEMI of 30% is no different to our own finding. We observed a high incidence of no-reflow in this cohort [14/25 (56%) patients had no reflow], which might be histopathologically related to the late presentation.

Conclusion: In this single-center study, one-third of patients with STEMI who were candidates for primary PCI treatment have non-fresh thrombus. This study encourages the adoption of a more effective first response system as part of the Saudi STEMI program including greater efforts to enhance patient and physician education.

Copyright

© 2020 Dr. Sulaiman Al Habib Medical Group. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Owayed Al Shammeri
AU  - Hala El-Saka
AU  - Bushra E. Al-Hutahly
AU  - Alaa E. Abd Elmoniem
PY  - 2020
DA  - 2020/11/18
TI  - Call for Awareness: ST-Segment Elevation Myocardial Infarction Presentation is Delayed more than What We Expect
JO  - Dr. Sulaiman Al Habib Medical Journal
SP  - 36
EP  - 39
VL  - 3
IS  - 1
SN  - 2590-3349
UR  - https://doi.org/10.2991/dsahmj.k.201105.001
DO  - 10.2991/dsahmj.k.201105.001
ID  - AlShammeri2020
ER  -