Key result
Diagnosis of Killip class 3 and 4 was significantly associated with poor treatment outcomes in patients with acute coronary syndrome compared to Killip class 1 and 2 (AOR 16.29).
Why the study?
Despite the increasing burden of ischemic heart disease in Ethiopia, acute coronary syndrome is a neglected area with limited data on treatment outcomes and associated factors.
Cross-Sectional (n=216)
No
Odds Ratio: 16.29 (95% CI 5.7–46.56)
Absolute Event Rate: 66.7% vs 9.8%
p-value: p=0.001
In an Ethiopian hospital, nearly a quarter of ACS patients experienced poor in-hospital outcomes, strongly driven by delayed presentation (>48 hours), advanced age, and severe presentation (Killip class 3-4, heart failure).
Background Acute coronary syndrome is the leading cause of death and disability globally, with low- and middle-income countries bearing a high proportion of the burden. Despite the increasing burden of ischemic heart disease in Ethiopia, acute coronary syndrome is a forgotten domain and few data are available. This study aimed to assess treatment outcomes and associated factors of acute coronary syndrome at Hiwot Fana Comprehensive Specialized Hospital. Method We conducted an institutional retrospective cross-sectional study of 216 randomly selected patients with acute coronary syndrome admitted to Hiwot Fana Hospital during the study period. Data were collected from medical records using a checklist. The information was entered into Epi Data version 4.2 and then exported to SPSS version 20.0 for analysis. Bivariable and multivariable logistic regression analysis was performed to identify factors associated with treatment outcome of patients with acute coronary syndrome. variables with a p -value of < 0.25 in the bivariable logistic regression analysis were entered into the multivariable analysis. Finally, significance was declared at a p -value < 0.05. Result Out of 216 participants, more than half 131(60.7%) were males, and 124 (57.41%) were urban residents. The average time between onset of symptoms and hospital admission was 23.1 ± 22.53 hr. The most common pattern of acute coronary syndrome was ST-elevation myocardial infarction 110 (50.9%). The poor treatment outcome of acute coronary syndrome was 50 (23.2%). Patients who arrived at the emergency department 48 hr after symptoms onset (AOR: 4.74; 95% CI: 1.29–17.40) received a diagnosis of Killip 3 and 4 (AOR: 16.29; 95% CI: 5.70-46.56) and heart failure (AOR: 2.16(1.02–7.68) were significantly associated with poor treatment of patients with acute coronary syndrome. Conclusion In this study, poor treatment outcomes in acute coronary syndrome were high. Patients who arrived at the emergency department 48 h after onset of symptoms, those diagnosed with Killip 3 and 4, as well as those with heart failure and age over 65 years had a poor outcome. Therefore, it is very important to focus on reducing this factor and improving management by targeting this factor to reduce the associated mortality.
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Mogess et al. (2026) conducted a cross-sectional in Acute coronary syndrome (n=216). Killip class 3 and 4 vs. Killip class 1 and 2 was evaluated on Poor treatment outcome (composite of cardiovascular hospital death, referral to a higher-level facility due to critical clinical deterioration, or leaving against medical advice) (AOR 16.29, 95% CI 5.70-46.56, p=0.001). Diagnosis of Killip class 3 and 4 was significantly associated with poor treatment outcomes in patients with acute coronary syndrome compared to Killip class 1 and 2 (AOR 16.29).
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