Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 25:12:1520899.
doi: 10.3389/fcvm.2025.1520899. eCollection 2025.

Management of acute coronary syndrome in resource-limited set up: a summary of 4-year review of two hospitals in Ethiopia

Dejene Atinafu Kebede  1 , Tamirat Godebo Woyimo  2 , Megersa Negesa Geleta  3 , Seifu Bacha Chiri  4 , Elsah Tegene Asefa  2 , Kedir Negesso Tukeni  2
Affiliations

Management of acute coronary syndrome in resource-limited set up: a summary of 4-year review of two hospitals in Ethiopia

Dejene Atinafu Kebede et al. Front Cardiovasc Med. .

Abstract

Introduction: Acute coronary syndrome refers to a group of diseases characterized by sudden, decreased blood supply to the heart muscle that results in cell death, also known as acute myocardial infarction. This results in severe chest pain or discomfort, with the subsequent release of cardiac biomarkers, and alterations in the electrocardiogram. It can cause diminished heart function and mortality if not treated properly with suitable measures. Despite the fact that percutaneous coronary intervention is the standard of care in one subset of acute coronary syndrome, significant number of patients were treated medically due to the limited service in the setting. The purpose of this study was to look at the patterns of acute coronary syndrome (ACS), as well as the management and outcomes of these patients in two Ethiopian tertiary institutions.

Methods: A four-year retrospective study was undertaken on 308 patients with acute coronary syndrome, at two tertiary hospitals located in Ethiopia's capital-Addis Ababa.

Results and discussion: Of the 308 patients 72.4% were male, with the average age of 56.3 ± 13.5 years. Hypertension and diabetes were the two most common risk factors identified. The average time to present to the emergency room after symptom onset was 3.7 (SD ± 3.2) days. The majority of patients (67.9%) have been diagnosed with ST- Elevated Myocardial Infarction and were classified as Killip class I. Percutaneous Coronary Intervention was performed for 12.3% of patients, with the remaining receiving medical care. The average hospital stay was 8.51 (SD ± 7.2) days while In-hospital mortality was 8.8%. Tachycardia of >140 (AOR = 7.50, 95% CI: 1.36, 41.57), any degree of left ventricular dysfunction, Killip class IV (AOR = 6.03, 95% CI: 1.27, 28.61), and non-initiation of betablockers (AOR = 0.17,95% CI: 0.05, 0.63) were significantly associated with increased in-hospital mortality.

Keywords: Ethiopia; PCI; STEMI; acute coronary syndrome; beta-blockers; heart failure; klipp class.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Presenting symptoms of patients with acute coronary syndrome admitted to Saint Paul Hospital Millennium Medical College and Saint Peter Hospital, Addis Abeba, Ethiopia (2020-2024).
Figure 2
Figure 2
Time of arrival from symptom-onset of patients with acute coronary syndrome admitted to Saint Paul Hospital Millennium Medical College and Saint Peter Hospital, Addis Abeba, Ethiopia (2020-2024).
Figure 3
Figure 3
Types and killip classification of patients with acute coronary syndrome admitted to Saint Paul Hospital Millennium Medical College and Saint Peter Hospital, Addis Abeba, Ethiopia (2020-2024).
Figure 4
Figure 4
Outcomes of coronary angiography of patients with acute coronary syndrome admitted to Saint Paul Hospital Millennium Medical College and Saint Peter Hospital, Addis Abeba, Ethiopia (2020-2024).
Figure 5
Figure 5
Outcomes of patients with acute coronary syndrome admitted to Saint Paul Hospital Millennium Medical College and Saint Peter Hospital, Addis Abeba, Ethiopia (2020-2024).
See this image and copyright information in PMC

References

    1. Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. (2014) 64(24):e139–228. 10.1016/j.jacc.2014.09.016 - DOI - PubMed
    1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. (2006) 3(11):e442. 10.1371/journal.pmed.0030442 - DOI - PMC - PubMed
    1. Guo JJ, Chen Y, Du W, Peng H, Wang R, Xia Y, et al. Antithrombotic therapy and direct medical costs in patients with acute coronary syndrome in Shanghai, China. Value Health Reg Issues. (2016) 9:1–7. 10.1016/j.vhri.2016.01.001 - DOI - PubMed
    1. Wilkins E, Wilson L, Wickramasinghe K, Bhatnagar P, Leal J, Luengo-Fernandez R, et al. European Cardiovascular Disease Statistics 2017. 5th ed. Brussels: European Heart Network; (2017):1–72.
    1. Bazzino O, Monaco R, Mario B, Sergio C, Valeria CM, Sergio E, et al. Management of acute coronary syndromes in developing countries: acute coronary events—a multinational survey of current management strategies. Am Heart J. (2011) 162(5):852–9. 10.1016/j.ahj.2011.07.029 - DOI - PubMed

LinkOut - more resources