Prevalence and Clinical Characteristics of Acute Coronary Syndrome in a Nigerian Tertiary Hospital.

Background: Acute coronary syndrome (ACS) is increasingly recognized across sub-Saharan Africa due to rising cardiometabolic risk factors. However, contemporary data from Northwestern Nigeria remain limited. This study aimed to determine the prevalence, clinical characteristics, and risk factors of ACS among patients admitted to Aminu Kano Teaching Hospital (AKTH) in Kano, Northern Nigeria. Methodology: A hospital-based, cross-sectional study was conducted over 13 months. Consecutive adult patients diagnosed with ACS according to ACC/AHA criteria were enrolled. Data on demographics, risk factors, presentation, and laboratory findings were collected using a semi-structured questionnaire. Prevalence was calculated with 95% confidence intervals (CI). Continuous variables were expressed as mean ± standard deviation or median [interquartile range], and compared using Student's t-test or Mann-Whitney U test. Categorical variables were expressed as frequencies (percentages) and compared using Chi-square or Fisher's exact test. Statistical analysis was performed using SPSS software version 18.0, and a P-value <0.05 was considered significant. Results: Among 2001 general medical admissions and 564 cardiovascular admissions, 55 patients had ACS, yielding prevalence rates of 2.8% (95% CI: 2.1-3.6%) and 9.8% (95% CI: 7.5-12.5%), respectively. The mean age was 60.5±12.2 years, and 61.8% were male. Females were older than males (65.6±11.2 vs. 57.4±11.8 years, P=0.014). The predominant risk factors were hypertension (87.3%), physical inactivity (81.8%), dyslipidaemia (74.5%), and diabetes mellitus (40.0%). ST-segment elevation myocardial infarction (STEMI) was the commonest subtype (60%). Diabetes mellitus was associated with STEMI, while obesity was associated with unstable angina (P<0.05). Most patients (83.6%) presented beyond 12 hours after symptom onset. Conclusions: ACS represents a significant proportion of cardiovascular admissions in Northwestern Nigeria, dominated by hypertension and metabolic disorders. There is an urgent need for public health interventions targeting modifiable risk factors and strategies to reduce pre-hospital delays.