Percutaneous Coronary Intervention in Africa: A Systematic Review of Associated Outcomes

Percutaneous coronary intervention (PCI) is a minimally invasive procedure that plays an important role in relieving an occlusion of the coronary arteries, allowing blood circulation to the cardiac tissues. It is central to the management of coronary heart disease. In recent years, there has been an increase in the use of PCI across the African continent, and this review aims to evaluate and report the clinical outcomes of PCI use in Africa among patients with coronary heart disease. A comprehensive search was conducted on PubMed, EMBASE via Ovid, and AJOL (African Journals Online) from inception to February 2025. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in this study. Three hundred two articles underwent full screening following predefined eligibility criteria, and 31 articles were included for qualitative analysis. The primary outcomes assessed were all-cause mortality and major adverse cardiovascular events (MACE). Secondary outcomes included post-procedural outcomes like complications and post-procedure thrombolysis in myocardial infarction (TIMI) flow grade. This review synthesized 31 articles from nine African countries. A total of 11,507 patients participated in this study, and 10,701 patients underwent PCI procedures, with stenting being the most common technique employed. Among participants, 8,620 (74.3%) are male, and 2,887 (24.8%) are female. A total of 170 (17.8%) cases of MACE were reported, and an overall mortality of 457 (4.9%) was reported. In-hospital mortality accounted for 317 of the total mortality, making up 4.7% of the assessed patients. About 78.2% of patients who underwent PCI achieved post-procedure TIMI flow grade III, an indicator of post-procedure reperfusion success rate in the study. The most common complications reported include: Heart failure (19.1%), arrhythmia (9.1%), revascularization (8.9%), coronary events (8.1%), structural complications (8.1%), and the need for intensive care unit support (7.9%). An allergic reaction (4.7%), a rare complication, was also reported. The study shows that mortality rates are relatively higher when compared to higher-resource countries. STEMI remains the predominant indication for PCI, underscoring a healthcare system that is still largely reactive rather than preventive. The high burden of comorbidities such as smoking, hypertension, and diabetes, paired with complication rates including heart failure and MACE, reflects systemic gaps in both acute and chronic cardiovascular care. To improve outcomes and close the equity gap, African health systems must prioritize context-sensitive guideline implementation, capacity building, and continuity of care.