Acute Coronary Syndrome: A Retrospective Study of the Epidemiological and Evolutionary Profile of Patients Hospitalized at the Agadir Regional Hospital in Southern Morocco

Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide. The diagnosis can be made based on the patient's history, the symptoms presented, the results of the electrocardiogram, and cardiac biomarkers. These elements help differentiate ST-elevation Myocardial Infarction (STEMI) from non-ST elevation acute coronary syndrome (NSTE-ACS). The aim of this work is to outline an epidemiological, clinical, and evolutionary profile of acute coronary syndrome treated at the Hassan II Regional Hospital Center in the Souss-Massa region.

This is a monocentric, retrospective epidemiological study with an analytical aim. The study focused on patients admitted to the cardiology center during the period from January 2019 to May 2022. Overall, 318 files of patients hospitalized for acute coronary syndrome in the cardiology department of the Souss-Massa Regional Hospital were analyzed. Aspecialized survey form was developed for this study to determine the socio-demographic, clinical, therapeutic, and evolutionary characteristics of the participants.

The average age was 62.3 ± 13.3 years, with a male predominance of 64.5%. The most common antecedents were hypertension (41.2%), diabetes (40.5%), and smoking (31.5%). The main reason for consultation was chest pain (91.2%) along with other atypical signs, such as dyspnea (30.5%), epigastric pain (17.7%), vomiting (16.4%), and syncope (2.8%). The analysis of the ECG revealed that 64.2% of the cases of acute coronary syndrome had a STEMI, and 35.8% had an NSTEMI. About 98.4% of patients received thrombolytic treatment.

The study revealed a significant association between ACS and the following risk factors: male sex (AOR= 3.12; CI 95% [1.71-5.70]), investigative methods, such as chest X-ray (AOR=0.15; CI95% [0.02-0.84]), treatment modalities, such as cardiac rehabilitation (AOR=0.07, CI95% [0.01-0.54]), statins (AOR=2.15; CI95% [1.20-3.85]) and favorable evolution (AOR=0.32; CI95%[0.13-0.77]). Mechanical complications were the most observed, with a percentage of 12.2%, and the in-hospital mortality rate was 5.3%.

In summary, this study provides new insights into the epidemiology and management of ACS in the Souss-Massa region while highlighting the specific challenges associated with the local hospital setting. Enhancing cardiovascular healthcare infrastructure, increasing awareness of risk factors, and optimizing prehospital management strategies are essential to improving the prognosis of ACS patients in Morocco.