Recovery Rate and Predictors Among Patients with Acute Coronary Syndrome in Addis Ababa, Ethiopia: A Retrospective Cohort Study

Abstract

Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity in the world, including Ethiopia. Over seven million people die annually due to acute coronary syndrome (ACS) secondary to CAD. Despite this fact, studies are scant in Ethiopia. Objective: To determine recovery rate and predictors of time to recovery among ACS patients in St. Peter's Specialized Hospital, Addis Ababa, Ethiopia from October 2017 to October 2019. Methodology: A retrospective cohort study was conducted among ACS patients. Patient charts were reviewed using a structured checklist. The Kaplan-Meier survival curve was used to estimate the survival time. Log-log plots were used to check proportional hazard assumption among categorical predictors. Bivariable and multivariable Cox regression analyses were performed to identify predictors of time to recovery. In bivariable analysis, variables with P ≤0.25 were fitted for multivariable Cox regression. Factors with P <0.05 in the multivariable Cox regression were independent predictors of time to recovery. Results: A total of 471 patient charts with a diagnosis of ACS were reviewed. The mean length of hospital stay was 2.98 ±1.30 days with a total follow-up time of 1397 person-days. The recovery rate was 61.8%. The incidence density rate of recovery was found to be 20.5 per 100 person-days. Percutaneous coronary intervention (PCI) (AHR = 2.08, 95% CI: 1.57, 2.74) and absence of major bleeding (AHR = 1.44, 95% CI: 1.11, 1.87) were predictors of time to recovery. Conclusion:In the current study, a considerable number of patients recovered within the first few days of admission. Absence of major bleeding and PCI were found to enhance early recovery of patients. Hence, early implementation of PCI and treatment of major bleeding may be vital to augment early recovery of patients with ACS. This can be achieved through involving case managers who can enhance the quality of treatment.

Epidemiological Characteristics and Risk Factors Associated with Acute Myocardial Infarction in Somalia: A Single-Center Experience

“…1 According to the risk factors of AMI during our investigation, hypertension (31 (41.2%) patients with STEMI and 14 (66.7%) patients with NSTEMI), diabetes (36 (49.3%) patients with STEMI as well as 11 (45.8%) patients with NSTEMI), and family history of CAD (24 (32.9%) patients of STEMI and 11 (45.8%) patients with STEMI), hyperlipidemia (15 (20.5%) patients with NSTEMI and 6 (25%) patients with STEMI) were the highest prevalence ASCVD risk factors of our study which is compatible with the other studies reported from Greece, India, Ethiopia, Kenya. 13,16,21,22 Moreover, in the present study, a large proportion of STEMI patients were more likely to have a current or previous history of cigarette smoking (39.7%), chat chewing (37%), and coffee drinking (31.5%), but they were less likely to have renal failure and COVID-19 pneumonia which is similar which is similar to previous data reported from Greece and South Trinidad. 13,23 In contrast to our research, data from Ethiopia found that NSTEMI patients had a history of smoking when compared to STEMI patients (64.9% vs 35.1%).…”

“…13 , 23 In contrast to our research, data from Ethiopia found that NSTEMI patients had a history of smoking when compared to STEMI patients (64.9% vs 35.1%). 21 …”

Optimal Medical Therapy for Secondary Prevention of Acute Coronary Syndrome: A Retrospective Study from a Tertiary Hospital in Sudan

“…Yet, these percentages were higher than Ethiopian and Bangladesh studies. 13 , 14 , 20 , 24 , 28 Similarly, 97.5% were on dual antiplatelet aspirin plus clopidogrel or ticagrelor (only in four patients), which was agreed with Iraqi and Bangladesh studies. 14 , 20 The low utilization of ticagrelor might be justified by higher cost, and it is not included in governmental and private insurance in Sudan.…”

“…16 In the present study, 99.5% of patients were using statin; this was higher than previously published reports. 13 , 14 , 20 , 24 , 28 Furthermore, ACEIs (or ARBs in cases of intolerance to ACEIs) are recommended in patients with anterior infarction, heart failure with reduced LVEF (<40%), diabetes, or chronic kidney disease (CKD) unless contraindicated in order to reduce cardiovascular mortality and cardiovascular morbidity. 16 In this study, 57.9% of patients were on either ACEIs or ARBs, compared with the literature; it was considered lower than other reports.…”

Lower paraoxonase 1 paraoxonase activity is associated with a worse prognosis in patients with non-ST-segment elevation myocardial infarction in long-term follow-up

“…In the first, approximately 48% of patients were diagnosed with STEMI, 31% with NSTEMI and 21% with UA [22]. In the study of Tsegaye et al [23], 33% of patients had STEMI, 28% had NSTEMI and 39% had UA. Even in studies involving more than one center, differences are observed.…”