ABSTRACT

Background: Acute Coronary Syndrome (ACS) is the leading cause of death and loss of disability-adjusted life years (DALYs) in the world, particularly in low- and middle-income countries. The present study aimed to examine management trends in acute coronary syndrome (ACS) at a prominent tertiary hospital in Sudan. Methodology: This is a prospective descriptive hospital-based study conducted at Al Shaab Teaching Hospital in Khartoum, Sudan, the country's principal tertiary hospital, which hosts the National Cardiac Center. The study includes all patients admitted to the emergency department with ACS, irrespective of demographic characteristics. The study includes all patients hospitalized in the emergency department with ACS, irrespective of demographic characteristics. Results: We enrolled 110 patients with ACS, aged 35 to 78 years, including 66.4% males and 33.6% females. Most of the patients (74.5%) were diagnosed with ST-elevation ACS (STE-ACS), with 62% being males. The relative risk (RR) of males developing ACS is 0.792, with a 95% confidence interval (95% CI) of 0.612 to 1.023 and a P-value of 0.086. Most of the patients (72.7%) received streptokinase thrombolysis. About 1.8% of patients had primary percutaneous coronary intervention (PPCI), and 44.5% had percutaneous coronary intervention (PCI). Around 25.5% had a coronary angiography (CAG) for NSTA-ACS. PCI was performed on 44.5% of patients, while 32.7% received medicinal therapy, 18% were discharged from the cardiothoracic-cardiology conference (CTC), and 5% underwent coronary artery bypass graft surgery. Conclusion: ACS, especially NSTE-ACS, predominates in men; streptokinase thrombolysis dominates treatment with PCI and limited PPCI. Angiographic disease load is mostly SVD, and severe disease presentation is common. ACS type and treatment routes differ by gender; however, the RR for males was not statistically significant, indicating that more research is needed to validate sex-related risk differences.

Keywords: Acute Coronary Syndrome, STEMI, NSTEMI, Thrombolysis, PCI, Sudan