TREATMENT OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME AND ITS MODIFIED RISK FACTORS IN SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA ETHIOPIA

Abstract

Abstract Background: Acute coronary syndrome is a coronary artery disease caused by a narrowing or blockage of the artery lumen. Because of the decreased oxygen supply, artery narrowing or blockage causes myocardial cell death. In Ethiopia, the treatment outcome of ACS has been observed to be poor, with an increase in patient death and in-hospital complications. Controlling cardiovascular risk factors is critical for avoiding negative cardiovascular outcomes. As a result, early detection and intervention of standard modifiable risk factors such as hypercholesterolemia, hypertension, smoking, and diabetes mellitus are critical. Objectives: To assess the treatment outcome of ACS patients and it modified risk factors in those patients who are admitted in Saint Paul’s hospital millennium medical college in Addis Ababa, Ethiopia from December, 2020- November, 2023 G.C. Methods: A Hospital based cross-sectional study among ACS patients at SPHMMC was conducted from December, 2020 to November, 2023 G.C. All in hospital ACS patients was used as a sample study population. Data was collected using a Data abstraction sheet from the participants’ medical records. Data was entered in to kobo toolbox application format and was analyzed using SPSS 26 the results. P-value < 0.05 to be considered as statistically significant association. Result: A total of 144 patients' data were examined; their mean (SD) age was 57(10.4), and more than half of them were male. The most typical clinical presentation was chest pain and shortness of breath. The identified modified risk factor is hypertension. Overall, ACS mortality rate was 6.9%. The adjusted multivariable regression model showed, developing cardiogenic shock, serum creatinine level and receiving treatment with beta blockers were found to have statistically significant association with mortality. Patients who developed cardiogenic shock were 3 times more likely to die than patient who did not develop cardiogenic shock (AOR: 3.296, 95% CI:1.590,6.351, p-value: 0.024). patients with serum creatinine 1.2 mg per dL and above were 25 times more likely to die than patients with serum creatinine less than 1.2 mg per dL (AOR:25.504, 95% CI: 1.299, 50.06, p-value: .033). patients which received beta blocker were less likely to die than patients who did not received beta blockers (AOR: 0.013, 95% CI: 0.003,0.930, p-value: 0.046). Conclusion and recommendation: ACS and other related vascular disease rising in alarming rate and becoming the public health burden. Hypertension and Diabetes mellitus are the commonest risk factor with undeniable rate of dyslipidemia. And to have a favorable outcome in patients with ACS there should be wide distribution for accessibility for the advanced therapy like PCI in at least territory hospitals & availability of thrombolytic in public pharmacy. It also good if equipping the local health centers with ECG machines, in order to avoid unnecessary delayance in referring the patients. Keywords: Acute coronary syndrome, ACS treatment outcome, ACS risk factors