Abstract
Background
Coronary artery disease (CAD) is the leading cause of death globally, with unique challenges in Sub-Saharan Africa. This study examines the clinical profile, angiographic severity, and in-hospital outcomes of percutaneous coronary interventions in a Teaching Hospital in Ghana.
Methods
We retrospectively reviewed coronary angiography and percutaneous coronary interventions performed at Korlebu Teaching Hospital between January 2017 and December 2022. This included demographic data, atherosclerotic cardiovascular disease (ASCVD) risk factors, clinical presentation, lesion severity, type of intervention, and in-hospital outcomes.
Results
463 patients were analyzed, with a median age of 60 years. The most prevalent ASCVD risk factors were hypertension (81.4%), old age (61.9%), dyslipidemia (39.6%), diabetes mellitus (35.5%), and obesity (25.8%). Most of the patients had three or more ASCVD risk factors. 127 patients (27.5%) had normal coronary angiograms, 74 (16.0%) had mild non-obstructive CAD, 90 (19.5%) had single-vessel disease, 70 (15.2%) each had two-vessel disease, and three-vessel disease respectively. Thirty-one patients (6.7%) had significant left-main disease. Twice more males than females had severe three-vessel and left-main disease. Although Akans comprised the majority, Ga-Adangbe had more three-vessel and left-main diseases. Six patients (1.3%) died, five of whom were males. The in-hospital mortality rate was higher in emergency cases than in elective cases (6.6% versus 0.3%, p-value < 0.001)
Conclusion
Many patients referred for coronary angiography had multiple ASCVD risk factors. Many of the patients had obstructive coronary artery disease and underwent successful PCI in a resource-constrained center. PCI outcomes were better in elective than emergency cases.