Management of ST-segment elevation acute coronary syndromes in the emergency department of Gabes

<h2>Abstract</h2><h3>Introduction</h3> Acute coronary syndromes (ACS) are one of the leading causes of morbidity and mortality in Tunisia. Timely and effective management in the emergency department is crucial to improving patient outcomes, particularly in cases of ST-segment elevation myocardial infarction (STEMI). <h3>Objective</h3> To study the prognosis and management of acute coronary syndromes in the emergency department. <h3>Methods</h3> A retrospective, monocentric, cross-sectional, descriptive, and analytical study was conducted at the critical emergency unit of Mohamed Ben Sassi University Hospital in Gabes. The study covered a period from January 1, 2020, to December 31, 2022, lasting 36 months. <h3>Results</h3> The mean age of patients was 65.2 ± 13.52 years, with a male-to-female ratio of 3.08. Forty-eight percent of patients were from Gabes city. In 80 % of cases (n = 269), at least one comorbidity was observed, including diabetes (152 patients), hypertension (124 patients), and coronary artery disease (28 patients). Chest pain was the most common symptom, noted in 95.3 % of cases (n = 323). Only 33 patients (9.73 %) had first medical contact within 1 h. Antithrombotic therapy was administered to 97.34 % of patients, and morphine was used in 18 % of cases. Thrombolysis was performed in 36.3 % of cases, with a success rate of 82.9 %. Angioplasty was performed in 10.02 % of cases. Of the patients, 90.26 % were transferred to a coronary care unit (CCU), while 3.53 % were transferred to intensive care, and 6.19 % died. <h3>Conclusion</h3> Predictive factors for thrombolysis failure in the acute phase of STEMI are critical for improving emergency management strategies.