Key result
ACS in Ethiopia carries ~15% in-hospital mortality, with higher rates in STEMI.
Why the study?
ACS is a principal cause of death in developing countries including Ethiopia, but no study had reported the overall patterns of risk factors and burden of in-hospital mortality in Ethiopia.
Meta-Analysis (n=1,197)
Effect estimate: 14.82% (95% CI 6.06-23.57)
In Ethiopia, acute coronary syndrome is associated with a high in-hospital mortality rate of 14.82%, highlighting significant gaps in guideline-directed medical therapy and access to reperfusion.
High ACS in-hospital mortality in Ethiopia signals urgent care access gaps; leaves open which interventions most effectively reduce deaths in similar settings.
Acute coronary syndrome (ACS) is the principal cause of death in developing countries including Ethiopia. No study reports the overall patterns of risk factors and burden of in-hospital mortality in Ethiopia. This study, therefore, aimed to assess the magnitude of risk factors, management, and in-hospital mortality of ACS in Ethiopia. Electronic searching of articles was conducted using PubMed, Science Direct, EMBASE, Scopus, Hinari, and Google Scholar to access articles conducted in Ethiopia. The Preferred Reporting Items for Systematic Reviews checklist was used for identification, eligibility screening, and selection of articles. Data were extracted with an abstraction form prepared with Microsoft Excel and exported to STATA for analysis. Funnel plot, Begg’s test, and Egger’s test were used to determine publication bias. Heterogeneity between the studies was checked by I2 statistic. The pooled prevalence of risk factors and in-hospital mortality of ACS were estimated using a random-effects meta-analysis model. Most (59.367%) of the patients had ST-segment elevation myocardial infarction (STEMI). Hypertension (54.814%) was the leading risk factor for ACS followed by diabetes mellitus (38.549%). Aspirin (56.903%) and clopidogrel (55.266%) were most frequently used in patients with STEMI ACS, respectively. The pooled proportion of in-hospital mortality of ACS was 14.82% which was higher in patients with STEMI (16.116%). The rate of in-hospital mortality is still high which was higher in patients with STEMI. Initiation of treatment must consider the heterogeneity of each patient’s risk factor and reperfusion therapy should be implemented in our setting.
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Kebede et al. (2023) conducted a meta-analysis in Acute coronary syndrome (n=1,197). Acute coronary syndrome was evaluated on In-hospital mortality (14.82%, 95% CI 6.06-23.57). Among patients with acute coronary syndrome in Ethiopia, the pooled in-hospital mortality rate was 14.82%, with higher mortality observed in those with STEMI (16.12%).
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