What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease and acute coronary syndromes (n=121). Intervention: Coronary angiography with or without percutaneous coronary intervention. Primary outcome: In-hospital mortality.

April 24, 2026Open Access

Clinical Presentation, Angiographic Characteristics, and In-Hospital Outcomes of Young Adults Undergoing Coronary Angiography in a Resource-Limited Sub-Saharan Setting

Key Result

In young adults undergoing coronary angiography in a resource-limited setting, in-hospital mortality was 9.9% and was significantly associated with cardiogenic shock, khat use, and delayed reperfusion.

Key Points

This study aims to assess the clinical presentation and in-hospital outcomes of young adults undergoing coronary angiography in resource-limited settings.
Retrospective analysis of patients aged ≤ 45 years undergoing coronary angiography.
Collection of demographic data, risk factors, angiographic characteristics, and in-hospital outcomes.
Primary outcome focused on in-hospital mortality.
121 patients included with a median age of 41; 45.5% experienced ST-elevation myocardial infarction.
Significant delays observed with a median door-to-balloon time of 355 minutes.
In-hospital mortality was 9.9%, linked to high-risk factors such as khat use and prolonged reperfusion delays.

Study Design

Type

Observational (n=121)

Multicenter

Structured PICO

Population

121 consecutive patients aged ≤ 45 years (median age 41, 77.7% male) who underwent coronary angiography, with or without percutaneous coronary intervention, for acute coronary syndromes (STEMI, NSTEMI, or unstable angina) and stable coronary artery disease in a Sub-Saharan catheterization center. Excluded: prior coronary artery bypass graft surgery, known congenital or structural heart disease, or incomplete angiographic data.

Intervention

Coronary angiography with or without percutaneous coronary intervention (PCI)

Outcome

In-hospital mortalityhard clinical

Young adults undergoing coronary angiography in a resource-limited Sub-Saharan setting experience high in-hospital mortality (9.9%) driven by severe system delays (median door-to-balloon time 355 minutes) and region-specific risk factors like khat use.

Limitations

Retrospective, single-center design limits causal inference and generalizability
Incomplete documentation of some variables due to real-world practice in resource-limited settings
Data on procedural complications such as bleeding, stroke, and acute kidney injury were not consistently available
Long-term outcomes were not available, restricting assessment to in-hospital events
Small number of mortality events resulted in quasi-complete separation during multivariable modeling, precluding reliable identification of independent predictors

Abstract

Background: Premature coronary artery disease is increasingly observed in low- and middle-income countries; however, data on young adults undergoing invasive coronary evaluation in resource-limited settings remain scarce. This study assessed clinical presentation, angiographic findings, system-related delays, and in-hospital outcomes among young adults undergoing coronary angiography in a Sub-Saharan catheterization center. Methods: We retrospectively analyzed consecutive patients aged ≤ 45 years who underwent coronary angiography, with or without percutaneous coronary intervention, for acute coronary syndromes (ST-elevation myocardial infarction STEMI, non-ST-elevation myocardial infarction NSTEMI, or unstable angina) and stable coronary artery disease between June 2021 and June 2025. Demographic data, cardiovascular risk factors, angiographic characteristics, and in-hospital outcomes were collected. The primary outcome was in-hospital mortality. Results: A total of 121 patients were included (median age 41 years; 77.7% male). Acute coronary syndromes predominated, with ST-elevation myocardial infarction in 45.5%. Smoking (55.4%) and khat use (39.7%) were the most prevalent risk factors. System delays were substantial, with a median door-to-balloon time of 355 minutes and 79.3% exceeding 180 minutes. The left anterior descending artery was the most common culprit vessel, and multivessel disease was present in 36.4%. In-hospital mortality was 9.9% and was associated with cardiogenic shock, severely reduced left ventricular ejection fraction, no-reflow/slow-flow phenomena, khat use, and prolonged door-to-balloon time (p < 0.05). Conclusion: Young adults with acute coronary syndromes in resource-limited settings experience substantial early mortality associated with delayed reperfusion, high-risk presentation, and region-specific risk factors. Improving STEMI systems of care and targeting modifiable exposures such as smoking and khat use may help improve outcomes. Keywords: young adults, acute coronary syndrome, coronary angiography, khat, door-to-balloon time, resource-limited setting

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Cite This Study

Abdi et al. (Wed,) conducted a observational in Coronary artery disease and acute coronary syndromes (n=121). Coronary angiography with or without percutaneous coronary intervention was evaluated on In-hospital mortality. In young adults undergoing coronary angiography in a resource-limited setting, in-hospital mortality was 9.9% and was significantly associated with cardiogenic shock, khat use, and delayed reperfusion.

synapsesocial.com/papers/69eb0803553a5433e34b33fc https://doi.org/https://doi.org/10.2147/ijgm.s595282

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