TREATMENT PATTERN, OUTCOME AND ASSOCIATED FACTORS OF ACUTE CORONARY SYNDROME AMONG PATIENTS ADMITTED TO THREE TERTIARY HOSPITALS IN ADDIS ABABA, ETHIOPIA. A TWO AND HALF YEARS REVIEW

Abstract

Abstract Background: Acute coronary syndrome (ACS) remains the leading cause of death in most developing nations including Ethiopia. In-hospital mortality remains alarmingly high, partly due to delayed or inadequate use of evidence-based medical and reperfusion therapies like percutaneous coronary intervention (PCI) or thrombolysis. This study aimed to investigate the treatment outcomes of ACS patients following specific therapies and identify factors associated with treatment outcome in three tertiary hospitals in Addis Ababa, Ethiopia. Methods: A multicenter, retrospective, clinical chart review was conducted on a total of 384 patients from January 2021 to June 30, 2023. Convenience sampling was used to collect the data while structured checklist was used to collect data from patient card. Chisquare tests were used to assess associations between categorical variables, while binary logistic regression identified independent predictors of in-hospital mortality. Statistical significance was set at p < 0.05. Results: Out of 384 patient card reviews, the mean age of patients was found to be 56.74 ± 12.46 years, urban residence accounted for 91.1% of cases and male predominance was seen in 69.8% cases. ST segment elevation myocardial infarction (STEMI) was diagnosed in 81.5%. Medical therapy was given for all patients but only 10.9% underwent percutaneous coronary intervention and 1.6% received streptokinase. Heart failure (49.5%) was the most common complication. In hospital mortality was 8.3%; with cardiogenic shock (5.2%) being the leading cause of death. Older age (>65years), Killip class 4, and severely reduced ejection fraction (EF<30%) were independent predictors for death with AOR of 10.466, 74.848 & 20.044 respectively. Conclusion: Despite the availability of reperfusion therapies, the rate of in-hospital mortality was high attributed to lack of timely intervention. Therefore, emergency services with advanced setup should be accessible for improved survival of patients with ACS. Keywords: Acute coronary syndrome, Treatment outcomes of ACS, In-hospital mortality, Revascularization, Addis Ababa, Ethiopia