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Table 4 Summary of possible gaps and obstacles and the suggested actions needed to improve STEMI management in Egypt

From: Presentation, management, and outcomes of STEMI in Egypt: results from the European Society of Cardiology Registry on ST elevation myocardial infarction

Gaps and obstacles in STEMI management in EgyptActions needed to optimize STEMI management in Egypt
Patients with high prevalence of risk factorsPrimary prevention plan
Increased ischemic time and delayed presentationPublic awareness campaigns and patient education
Under use of EMSImproving EMS service quantitatively and qualitatively
Under use of primary PCIIncreased health care expenditure
Increase number of PPCI centers
Establish STEMI networks and protocols
Extend medical insurance
Expand reimbursement to PPCI centers
Educate and train medical personnel
Streptokinase is still widely usedReplace it with TNK
Encourage out of hospital thrombolytic therapy
Encourage routine PCI post thrombolysis
Clopidogrel is widely usedEncourage more potent antiplatelets
High in-hospital mortality rateReduce the number of non-reperfused patients
Registries and quality control