# Epidemiology and Short-Term Outcomes of Acute Coronary Syndrome in a Nigerian Tertiary Hospital: A Prospective Cohort Study

## TL;DR

This study examines the characteristics and outcomes of acute coronary syndrome patients in a Nigerian hospital, finding high mortality linked to older age and STEMI.

## Contribution

The paper provides new epidemiological data on ACS in Nigeria, highlighting risk factors and outcomes in a local context.

## Key findings

- Most patients were over 60 years old and male, with hypertension as the leading risk factor.
- STEMI was the most common ACS subtype and was associated with the majority of deaths.
- High mortality rates were observed, especially among older patients and those with elevated troponin T levels.

## Abstract

Background: Acute coronary syndrome (ACS) is associated with significant morbidity and mortality, with outcomes influenced by disease subtype and patient comorbidities. Data on the epidemiology and outcomes of ACS in Nigeria remain limited.

Objectives: This study aimed to describe the epidemiological characteristics, clinical presentation, and short-term outcomes of patients with ACS in a Nigerian tertiary hospital.

Methods: This was a prospective cohort study conducted at the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria, from May 11, 2022, to May 10, 2023. Thirty adult patients (n = 30) aged ≥18 years with a confirmed diagnosis of ACS were consecutively recruited and followed for three months. Data on sociodemographic characteristics, cardiovascular risk factors, clinical features, electrocardiographic and echocardiographic findings, and treatment outcomes were collected. Statistical analysis was performed using SPSS version 27 (IBM Corp., Armonk, NY), with statistical significance set at p < 0.05.

Results: The mean age of the patients was 59.0 ± 14.2 years, with the majority aged ≥60 years (19 patients, 63.3%). There were 20 male patients (66.7%) and 10 female patients (33.3%). The most prevalent cardiovascular risk factor was hypertension (22 patients, 73.3%), followed by alcohol intake (12 patients, 40%), dyslipidemia (six patients, 20%), and diabetes mellitus (five patients, 16.7%).

ST-segment elevation myocardial infarction (STEMI) was the most common ACS subtype (16 patients, 53.3%), followed by unstable angina (nine patients, 30%) and non-ST-segment elevation myocardial infarction (NSTEMI) (five patients, 16.7%).

Overall mortality was seven patients (23.3%), comprising in-hospital deaths in five patients (16.7%) and out-of-hospital deaths within three months in two patients (6.7%). Mortality was higher among patients aged ≥60 years (six of seven deaths, 85.7%) and among those with STEMI (six of seven deaths, 85.7%). Elevated cardiac troponin T levels were significantly associated with increased mortality (seven of seven deaths, 100%, p = 0.010).

Conclusion: Acute coronary syndrome predominantly affected older male patients, with hypertension and alcohol use being the most common risk factors. STEMI was the most frequent presentation and accounted for most deaths. The high short-term mortality rate in the index study underscores the need for improved early diagnosis, risk factor modification, and access to timely reperfusion therapies to improve outcomes.