Managing Acute Myocardial Infarction in Remote Oman: Real-world data from Al Wusta Governorate

Area of Science:

• Cardiology
• Public Health
• Health Systems Research

Background:

• Acute ST-segment elevation myocardial infarction (STEMI) is a critical medical emergency requiring rapid reperfusion.
• Management and outcomes of STEMI in remote, resource-limited settings are not well understood.
• This study investigates the effectiveness of reperfusion strategies in Oman's Al Wusta governorate.

Purpose of the Study:

• To explore the STEMI reperfusion network in Al Wusta, Oman.
• To evaluate the effectiveness of pharmacological thrombolysis in general practitioner (GP)-led hospitals.
• To identify predictors of thrombolysis failure in this specific population.

Main Methods:

• Retrospective review of administrative health registries and medical records (June 2017 - December 2024).
• Inclusion of patients presenting with STEMI who received pharmacological thrombolysis.
• Multivariate logistic regression analysis to determine predictors of thrombolysis failure.

Main Results:

• 139 patients received thrombolysis; 97.8% were male, mean age 47.8 years.
• Thrombolysis failure occurred in 9.4% of patients, accounting for all 3 deaths (2.2% mortality).
• Alcohol consumption (OR 4,417.7) and anterolateral STEMI (OR 48.9) were strongly associated with thrombolysis failure.

Conclusions:

• GP-led hospitals in Al Wusta achieved high rates of successful reperfusion.
• Failed thrombolysis remains a significant concern, with high mortality in this subgroup.
• Targeted interventions are needed to improve STEMI care in underserved regions.