ACS in Abidjan showed 9.5% in-hospital mortality with age, diabetes, Killip class ≥2, and severe ventricular rhythm disorders as independent predictors of death, while percutaneous coronary intervention was a protective factor.
ACS accounted for 20.0% of all ICU admissions at the Abidjan Heart Institute over the study period.
ACS occurred predominantly in relatively young patients with a strong male predominance.
Median time from symptom onset to hospital admission was 24 hours.
Overall in-hospital mortality was 9.5%, with a declining trend from 2019 to 2023.
Age was an independent predictor of in-hospital death after ACS in multivariate analysis.
Diabetes was an independent risk factor for in-hospital death after ACS.
Killip class ≥2 on admission was a strong independent predictor of in-hospital death.
Severe ventricular rhythm disorders were the strongest independent predictor of in-hospital death.
Percutaneous coronary intervention (PCI) was an independent protective factor against in-hospital death.
This research suggests that heart attacks (acute coronary syndromes, or ACS) are a major and growing health problem in Côte d'Ivoire, representing 1 in 5 admissions to the intensive care unit at the Abidjan Heart Institute over a five-year period. Patients tended to be relatively young (median age 57) and mostly male, and they often arrived at the hospital very late — a median of 24 hours after their symptoms began. Nearly 1 in 10 patients died during their hospital stay, though this rate improved notably over the study period, dropping from 11.2% in 2019 to 5.0% in 2023. The study identified several factors that were associated with a higher risk of dying in the hospital: older age, having diabetes, arriving with signs of heart failure (Killip class ≥2), and experiencing dangerous heart rhythm problems. On the other hand, patients who received a procedure to open blocked coronary arteries (percutaneous coronary intervention, or PCI) were significantly less likely to die — about 60% lower relative risk — highlighting the life-saving potential of this intervention, which was performed in just over half of patients. This research suggests that improving outcomes for ACS patients in this setting will require addressing delays in seeking care, expanding access to interventional procedures like PCI, and strengthening organized networks for ACS management. The findings also underscore the importance of managing cardiovascular risk factors such as diabetes and high blood pressure in the broader population.
Yao H, N'Zonzy S, Ekou A, Akoun C, Sepih E, Ehouman E, et al.. (2026). [Predictive factors for in-hospital death after acute coronary syndrome: Data from REACTIV registry 2019 to 2023].. Annales de cardiologie et d'angeiologie. https://doi.org/10.1016/j.ancard.2026.102036