Abstract:
The burden of cardiovascular diseases, particularly ischemic heart disease is
figured out to escalate in Ethiopia. Despite increasing burden of ischemic heart disease in
Ethiopian, acute coronary syndrome is a forgotten domain and a few data are available.
Objective: To assess treatment outcome of Acute Coronary Syndrome in patients admitted to
JUMC, and St. Peter Hospital, from March -August, 2018.
Methods: Prospective cohort study was conducted at Jimma University medical center and
St. Peter hospital in Ethiopia. Adult patients with confirmed ACS diagnosis were
consecutively included from March-August, 2018. Data on patient demography, presentation,
management and outcomes were collected and the patients were followed from admission to
30 days. Cox-regression model was used to determine predictors of 30 day survival.
Statistical significance was considered at p value <0.05
Results: A total of 181 patients with confirmed ACS were enrolled (61% with ST-elevation
myocardial infarction [STEMI], 39% with non–ST elevation–ACS). Mean (SD) age at
presentation was 56 (±12) years and did not differ among ACS types. The mean symptom
onset to hospital presentation time was 54hr, (±26). In-hospital and discharge anti-platelet
and statins use were high (>90%), although none of the patients get any form of early
revascularization. The use of beta-blockers and ACEIs were variable (80% vs 72%) in
hospital and (71%vs 70%) at discharge respectively. The overall 30 day mortality rate was
20% with higher death in STEMI (26%) compared to non-STMI/UA (11.4%). Non fatal
MACE was occurred in 22% patients. Rural residence (AHR=2.4 CI 1.23-4.66), STEMI
[AHR 3.05, (1.14- 8.89)], prior stroke [AHR 15.14, (3.61-63.50)], GRACE-Score [AHR
1.026, (1.01-1.04)], and cardiogenic shock [AHR 4.46 2.02-9.81)] were factors associated
with high risk of 30 day mortality after adjusted for confounders. Factor associated with a
lower risk were hemoglobin at admission (HR 0.843, CI 0.75-0.96).
Conclusion: The overall mortality of ACS in our study was alarmingly high, and reveals the
need of instantaneous intervention by government and other stakeholders to improve outcome
ACS patients.
