Clinical Features, Risk Factors, and Outcomes of Acute Coronary Syndrome in Young Sudanese Patients: A Retrospective Single-Tertiary Care Center Study

Background: Coronary artery disease (CAD) is a leading cause of death worldwide, even in young patients. This study aimed to characterize the clinical features, risk factors, and prognosis of acute coronary syndrome (ACS) in young Sudanese patients.
Methods: A total of 100 Sudanese patients aged up to 45 years with ACS were enrolled in a retrospective cross-sectional study at the Sudan Heart Center from 2022 to 2023. Their clinical data, including the findings, management, and outcome of their electrocardiogram (ECG), echocardiography, and coronary angiography within one month, were recorded and analyzed using the SPSS program version 25.
Results: Of the 100 patients, 74% were male and 26% were female, and the median age was 39. Risk factors included hypertension (33%), diabetes mellitus (30%), obesity (26%), and smoking (25%). ST-elevation myocardial infarction (STEMI) occurred in 73% of cases, mild ejection fractions occurred in 45 patients, and mitral regurgitation and left ventricular thrombosis each occurred in six patients. Most patients (73%) had occlusive CAD, primarily in the left anterior descending (LAD) artery (74%). Of the patients, 34% received thrombolysis, 26% had percutaneous coronary intervention (PCI), and 16% had coronary artery bypass grafting (CABG). Adverse events were significantly higher with a P-value of 0.000 in patients with diabetes, hypertension, a smoking habit, hyperlipidemia, obesity, occlusive CAD, and multivessel involvement (P = 0.001).
Conclusion: Classical risk factors, especially hypertension, continue to significantly contribute to CAD and ACS in young adults in Sudan. It is imperative to prioritize interventions to prevent or mitigate these risk factors, including implementing strategies for blood pressure regulation, blood glucose monitoring, smoking cessation, and lipid management in young adults.