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.
Observational (n=121)
No
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.
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
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.