Observational studyBMC emergency medicine2021
Management quality indicators and in-hospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study.
Observational study in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Clinical profiles, management, and outcomes of acute coronary syndrome patients in hospitals without reperfusion therapy: a multicentre study in Addis Ababa, Ethiopia.BMC cardiovascular disorders · 2026Article
- In-Hospital mortality and determinants among myocardial infarction patients in public hospitals, Northwest Ethiopia: evidence from sub-Saharan Africa.BMC cardiovascular disorders · 2026Article
- Article
- Sex differences in cardiovascular outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention.Journal of thoracic disease · 2025Article
- The Process of Inefficient Self-Management in Patients With Myocardial Infarction in Prehospital: A Grounded Theory.Health science reports · 2025Article
- Long-term all-cause mortality rate after ST-elevation myocardial infarction and its predictors: ST Elevation Myocardial Infarction Cohort in Isfahan Study.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2025Article
- Gender disparities in the mediating role of symptom knowledge level in reducing acute coronary syndrome (ACS) decision delay: Findings from a community-based study in China.BMC emergency medicine · 2023Article
- Article
- In-hospital mortality from acute coronary syndrome in Africa: a systematic review and meta-analysis.SAGE open medicine · 2023Review
- Optimal Medical Therapy for Secondary Prevention of Acute Coronary Syndrome: A Retrospective Study from a Tertiary Hospital in Sudan.Therapeutics and clinical risk management · 2022Article
- Management and 30-Day Mortality of Acute Coronary Syndrome in a Resource-Limited Setting: Insight From Ethiopia. A Prospective Cohort Study.Frontiers in cardiovascular medicine · 2021Article
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6 authors.
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Abstract
backgroundAcute coronary syndrome (ACS) remains the leading cause of cardiovascular disease mortality and morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So, this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients with ACS in Ethiopia.
methodsA Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018 to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality. Variable with p -value < 0.05 was considered statistically significant.
resultsAmong 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction (STEMI). The mean age of the study participant was 55.8 ± 11.9 years and 62.4% were males. The use of guideline-directed medications within 24 h of hospitalization were sub-optimal (57%) [Dual antiplatelet (73%), statin (74%), beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the percutaneous coronary intervention (PCI). Discharge aspirin and statin were high (> 90%) while other medications were sub-optimal (< 80%). The all-cause in-hospital mortality rate was 20.4% and the non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81-7.29), symptom onset to hospital arrival > 12 h (AHR: 4.23, 95% CI: 1.28-13.81), and Cardiogenic shock (AHR: 7.20, 95% CI: 3.55-14.55) were independent predictors of time to in-hospital death among ACS patients.
conclusionIn the present study, the use of guideline-directed in-hospital medications was sub-optimal. The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national quality-improvement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to reduce pre-hospital delay.
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