Coronary Lesions and Myocardial Revascularisation in Acute Coronary Syndrome in Lome

Introduction and objective: Acute coronary syndrome (ACS) is a cardiac emergency, and significant progress has been made in its management in Togo. This study aimed to describe coronary lesions in ACS patients and aspects of myocardial revascularisation. Materials and methods: This cross-sectional study was conducted at Dogta-Lafiè Hospital and Autel d'Elie Private Hospital in Lomé over four years and six months (January 2021 to June 2025). All patients who underwent coronary angiography for acute coronary syndrome during the study period were included. Results: Out of 298 requests for coronary angiography for ACS, 184 patients underwent the procedure. The coronary angiography performance rate was 61.75%. The mean patient age was 57.9 ± 12.6 years, with a male predominance (sex ratio 1.8). ST-segment elevation myocardial infarction (STEMI) accounted for 62.5%. Significant coronary lesions were found in 161 patients (87.5%), which were significantly more prevalent in STEMI than in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) (p = 0.0001). Depending on the complexity of the coronary lesions, type B lesions were significantly more prevalent in STEMI than in NSTE-ACS, while type C lesions were more prevalent in NSTE-ACS. Percutaneous coronary intervention was performed on only 86 patients (46.74% of those who underwent coronary angiography for ACS and 67.19% of those for whom percutaneous coronary intervention was indicated). Percutaneous coronary intervention was performed in 51 patients with STEMI (46.79%), including 13 cases of primary percutaneous coronary intervention (25.49%). Coronary artery bypass grafting was performed in 50% of patients for whom it was indicated. Two patients (1.56%) died from complications following angioplasty due to ventricular fibrillation. Conclusion: Coronary angiography is rarely performed in ACS, but it allows assessment of lesions. The rate of myocardial revascularisation also remains.