Registry for Acute Coronary Events in Nigeria (RACE-Nigeria): Clinical Characterization, Management, and Outcome

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Coronary artery disease (CAD) was historically uncommon in Africa, but acute coronary syndrome (ACS) now contributes significantly to morbidity and mortality.
• Existing data on ACS in Africa, particularly Nigeria, is limited, highlighting a need for current epidemiological insights.

Purpose of the Study:

• To determine the incidence, clinical characteristics, treatment patterns, and outcomes of ACS in indigenous Nigerian adults.
• To identify predictors of mortality in Nigerian patients experiencing ACS.

Main Methods:

• An observational, multicentered national registry study involving 1072 Nigerian patients with ACS between 2013 and 2018.
• Data collection focused on incidence, time to treatment, reperfusion rates, pharmacotherapy, major adverse cardiac events, and 1-year mortality.

Main Results:

• The incidence of ACS was 59.1 per 100,000 hospitalized adults annually, with ST-segment-elevation myocardial infarction being the most common type.
• Patients were relatively young (mean age 59.2 years), predominantly urban, and presented with significant delays in seeking medical attention.
• Reperfusion rates were low (thrombolysis 17.1%, PCI 28.6%), and 1-year mortality was 13.3%, with predictors including cardiac arrest, lack of reperfusion, and heart dysfunction.

Conclusions:

• ACS is a growing public health concern in Nigeria, characterized by a younger demographic and urban prevalence.
• Healthcare system limitations, including capacity and low reperfusion rates, significantly impact patient outcomes.
• Recommendations include implementing targeted preventive strategies and developing management guidelines tailored to the local healthcare infrastructure.