Acute coronary syndrome in young adults: a 5-year retrospective study at Hôpital Général Idrissa Pouye, Dakar, Senegal (2020-2024)

Acute coronary syndrome (ACS) in young adults (≤45 years) is an emerging and poorly documented entity in sub-Saharan Africa. Data on its epidemiological, clinical, therapeutic, and prognostic profile remain scarce, particularly in Senegal. We conducted a retrospective, single-centre study at HOGIP, Dakar, Senegal, over five years (January 2020-December 2024), including all patients aged 18-45 years hospitalised for ACS according to 2020 ESC criteria. Data were analysed using descriptive statistics (means ± standard deviations for continuous variables and absolute frequencies with percentages for categorical variables). Among 663 ACS hospitalisations, 53 (8.0%) involved young adults. The mean age was 38.2±5.3 years and 40 patients (75.5%) were male. The study population was predominantly urban (n=47, 89%) with a high prevalence of dyslipidaemia (n=34, 64.0%), psychosocial stress (n=28, 52.8%), and physical inactivity (n=19, 35.9%). STE-ACS was the predominant presentation (n=40, 75.5%), mainly in the anterior territory (n=27, 50.9%). Among the 34 patients (64.0%) who underwent coronary angiography, single-vessel disease was found in 20 (60.6%), with the left anterior descending artery as the culprit vessel in 26 (78.8%). Thrombolysis was performed in 16 patients (30.2%) with a success rate of 62.5% (n=10), primary PCI in 10 (18.9%), and 23 patients (43.4%) received medical therapy alone. In-hospital mortality was 3.8% (n=2). In this single-centre study at HOGIP, ACS in young adults predominantly affected men with multiple modifiable risk factors and single-vessel coronary lesions, with a relatively favourable in-hospital prognosis. The limited use of primary PCI highlights the need to strengthen interventional cardiology capacity in this setting.