Profil épidémiologique et modalités de prise en charge des syndromes coronariens aigus à l'hôpital mixte Laghouat après la mise en marche de la salle de cathétérisme cardiaque Aout 2025 /Avril 2026.

Abstract

Introduction: Acute coronary syndromes (ACS) represent a major public health issue, particularly in Algeria, in the context of the ongoing epidemiological transition. The opening of a catheterization laboratory at the Laghouat Mixed Hospital (LMH) in August 2025 marks a significant milestone in local cardiovascular care. The aim of this study is to describe the epidemiological profile and management modalities of ACS patients admitted to the LMH following this inauguration. Materials and methods: This is a descriptive study with dual recruitment (retrospective and prospective) including 150 patients admitted for ACS at the LMH over the period from August 5, 2025 to April 20, 2026. Results and discussion: During the study period, 150 patients were included, with a mean age of 59.4 ± 13.7 years and a marked male predominance (sex ratio 3.4:1). The cardiovascular risk profile was particularly heavy: diabetes in 54% of cases, hypertension in 52.7%, smoking in 51.3%, with an average of 3.3 risk factors per patient. ACS types were almost equally distributed: NSTEMI in 50.7%, STEMI in 46%, and Wellens syndrome in 2.7%. Typical chest pain was present in 92% of cases. The median symptom-to-admission delay was 6 hours (mean 12.9 hours), with only 33.1% of patients admitted within the first 3 hours. Angiographically, the left anterior descending artery (LAD) was the most frequent culprit vessel. The mean LVEF was 42.9%, and 28.2% of patients had an LVEF below 40%. The angiographic success rate (TIMI 3 post-PCI) was 89.6%. Prior thrombolysis was performed in 36.2% of STEMI patients. A coronary revascularization rate of 56% was achieved, including 18% by coronary artery bypass grafting (CABG). Adherence to guidelines (BASIC score) was 88%. In-hospital complications included heart failure in 15.3% and cardiogenic shock in 3.3% of patients. The in-hospital mortality rate was 3.3% (5 deaths out of 150), exclusively in the STEMI group (5.8% vs 0% for NSTEMI). The mean hospital stay was 4.1 ± 2.4 days, consistent with current international standards. Conclusion: The inauguration of the catheterization laboratory at the LMH has enabled a revascularization rate of 56% with a satisfactory angiographic success rate (89.6%). Nevertheless, reducing admission delays, intensively controlling cardiovascular risk factors — particularly diabetes and smoking — and establishing a structured regional STEMI pathway are absolute priorities to improve patient outcomes in our region.