Basic Clinical Characteristics and Hospital Outcomes of Acute Coronary Syndrome Patients-Sudan
Background: There are Variation in the presentation of the acute coronary syndrome between countries. The present study aimed to investigate the basic clinical characteristics and in-hospital outcomes among acute coronary syndrome patients in the Sudan.
Material and Methods: A cross-sectional comparative study conducted among 202 consecutive acute coronary syndrome patients at a reference coronary care unit in Omdurman Teaching Hospital between July 2014 and August 2015. Participants signed a written informed consent, and then a case report form was filled. Information collected include vascular risk factors, vital signs, echocardiographic findings, and in Hospital complications. The local ethical committee approved the research, and the chi-square test was used to compare ST-segment Elevation (STSEACS) and None ST-Segment Elevation Acute coronary syndrome (NSTSEACS).
Results: (out of 202 women (53.75%) in (NSEACS) P =0.009). Prior myocardial infarction, hypertension, diabetes mellitus, and, smoking were evident in 19.8%. 53.%, 30.2%, and 16.6% of acute coronary syndrome respectively, 97% of patients presented with chest pain, 54% presented to the hospital after 24 hours. Hypotension, heart failure, low ejection fraction, and in-hospital complications were more in (STSEACS) than (NSTSEACS), while (NSTEACS) patients received less Thrombolysis and Percutaneous coronary angioplasty P-value < 0.05
Conclusions: Acute coronary syndrome patients were younger and had more complications than others in the West. ST-Segment Elevation Myocardial Infarction Patients are more likely to develop in-hospital complications and to receive reperfusion therapy. The limitation of the study is the lack of follow-up information after discharge.
 J. A. Finegold, P. Asaria, and D. P. Francis, “Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations,” International Journal of Cardiology, vol. 168, pp. 934–945, 2012.
 A. Hersi, K. Al-Habib, H. Al-Faleh et al., “Gender inequality in the clinical outcomes of equally treated acute coronary syndrome patients in Saudi Arabia,” Annals of Saudi Medicine, vol. 33, no. 4, pp. 339–346, 2013.
 K. F. Alhabib, A. Hersi, H. Alfaleh, K. Alnemer, S. Alsaif, A. Taraben et al., “Baseline characteristics, management practices, and in-hospital outcomes of patients with acute coronary syndromes: Results of the Saudi project for assessment of coronary events (SPACE) registry,” Saudi Heart Assoc, vol. 4, pp. 233–239, 2011.
 H. L. Dauerman, D. Lessard, J. Yarzebski, M. I. Furman, J. M. Gore, and R. J. Goldberg, “Ten-year trends in the incidence, treatment, and outcome of Q-wave myocardial infarction,” American Journal of Cardiology, vol. 86, no. 7, pp. 730–735, 2000.
 V. Salomaa, H. Miettinen, P. Palomliki et al., “Diagnostic features of acute myocardial infarction - Changes over time from 1983 to 1990: Results from the FINMONICA AMI register study,” Journal of Internal Medicine, vol. 237, no. 2, pp. 151–159, 1995.
 P. G. McGovern, D. R. Jacobs Jr., E. Shahar et al., “Trends in acute coronary heart disease mortality, morbidity, and medical care from 1985 through 1997: The Minnesota Heart Survey,” Circulation, vol. 104, no. 1, pp. 19–24, 2001.
 M. C. Shibata, M. D. Flather, D. P. De Arenaza, D. Wang, and J. Conor O’Shea, “Potential impact of socioeconomic differences on clinical outcomes in international clinical trials,” American Heart Journal, vol. 141, no. 6, pp. 1019–1024, 2001.
 “MONICA Monograph and Multimedia sourcebook. World’s largest study of heart disease, stroke, risk factors and population trends,” GenevaWHO, pp. 1979–2002, 2003.
 M. Montaye, A. Bingham, D. Arveiler et al., “Interregional differences in the clinical, biological and electrical characteristics of first acute coronary events in France: results from the MONICA registries,” European journal of preventive cardiology, vol. 20, no. 2, pp. 275–282, 2013.
 S. Yusuf, M. Flather, J. Pogue et al., “Variations between countries in invasive cardiac procedures and outcomes in patients with suspected unstable angina or myocardial infarction without initial ST elevation,” Lancet, vol. 352, no. 9127, pp. 507–514, 1998.
 A. Orlandini, R. Díaz, D. Wojdyla et al., “Outcomes of patients in clinical trials with ST-segment elevation myocardial infarction among countries with different gross national incomes,” European Heart Journal, vol. 27, no. 5, pp. 527–533, 2006.
 A. M. Ahmed and N. H. Ahmed, “Diabetes mellitus in Sudan: The size of the problem and the possibilities of efficient care,” Practical Diabetes International, vol. 18, no. 9, pp. 324–327, 2001.
 WHO, The World Health Report 2002. Reducing Risks, Promoting Healthy Life, World Health Organization, Geneva, 2002.
 W.-C. Chang, W. K. Midodzi, C. M. Westerhout et al., “Are international differences in the outcomes of acute coronary syndromes apparent or real? A multilevel analysis,” Journal of Epidemiology and Community Health, vol. 59, no. 5, pp. 427–433, 2005.
 L. Mandelzweig, A. Battler, V. Boyko et al., “The second euro heart survey on acute coronary syndromes: characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004,” European Heart Journal, vol. 27, no. 19, pp. 2285–2293, 2006.
 S. G. Goodman, W. Huang, A. T. Yan et al., “The expanded Global Registry of Acute Coronary Events: Baseline characteristics, management practices, and hospital outcomes of patients with acute coronary syndromes,” American Heart Journal, vol. 158, no. 2, pp. 193–e5, 2009.
 A. T. Yan, R. T. Yan, M. Tan et al., “Management patterns in relation to risk stratification among patients with non-ST elevation acute coronary syndromes,” Archives of Internal Medicine, vol. 167, no. 10, pp. 1009–1016, 2007.
 A. El-Menyar, M. Zubaid, W. Rashed et al., “Comparison of men and women with acute coronary syndrome in six Middle Eastern countries,” The American Journal of Cardiology, vol. 104, no. 8, pp. 1018–1022, 2009.
 S. Dey, M. D. Flather, G. Devlin et al., “Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes: The Global Registry of Acute Coronary Events,” Heart, vol. 95, no. 1, pp. 20–26, 2009.
 K. F. AlHabib, A. Hersi, H. AlFaleh et al., “Baseline characteristics, management practices, and in-hospital outcomes of patients with acute coronary syndromes: results of the Saudi project for assessment of coronary events (SPACE) registry,” Journal of the Saudi Heart Association, vol. 23, no. 4, pp. 233–239, 2011.
 A. H. Al-Khadra, “Clinical profile of young patients with acute myocardial infarction in Saudi Arabia,” International Journal of Cardiology, vol. 91, no. 1, pp. 9–13, 2003. V