In-Hospital Mortality of Acute Coronary Syndromes Undergoing Coronary Angiography: A Multicenter Study in Dakar, Senegal

Acute Coronary Syndrome (ACS) significantly contributes to cardiovascular mortality worldwide, with an increasing prevalence in Africa due to rising cardiovascular risk factors. Despite advances in reperfusion therapies like percutaneous coronary intervention (PCI), many African countries, including Senegal, face substantial barriers to optimal care. This study aimed to assess in-hospital mortality among ACS patients undergoing coronary angiography in Dakar, Senegal, and to describe clinical features associated with mortality. We conducted a retrospective, multicenter, cross-sectional study involving patients hospitalized with ACS who underwent coronary angiography between January 2020 and June 2023 in three tertiary cardiology centers in Dakar. Demographic data, clinical presentation, cardiovascular risk factors, angiographic findings, and therapeutic interventions were collected. Statistical analysis included descriptive statistics and bivariate comparisons, with significance defined at p<0.05. Out of 2573 ACS patients undergoing coronary angiography, 30 died, resulting in an in-hospital mortality rate of 1.16%. The mean age was 61.2 ± 10.8 years, predominantly male (76.7%). Hypertension (53.3%) and sedentary lifestyle (83.3%) were common risk factors. Most patients presented with atypical chest pain (76.7%) and delayed hospital admission beyond 12 hours (43.3%). STEMI accounted for 70% of cases, with the left anterior descending artery frequently involved (80%). PCI using drug-eluting stents was performed in 56.7% of deceased patients. Cardiogenic shock was the leading complication (46.7%). In-hospital mortality following coronary angiography for ACS in urban Senegal is relatively low but delayed presentations and atypical symptoms remain significant barriers. Enhanced public awareness, reduced delays to intervention, and overcoming socioeconomic obstacles are essential to improve outcomes.