Describing final diagnosis and outcome for patients investigated for suspected acute coronary syndrome at a regional, public South African emergency centre

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BackgroundThe global burden of disease is shifting from communicable to non-communicable diseases including acute coronary syndrome.There is comparatively less data available regarding acute coronary syndrome in Sub-Saharan Africa compared to elsewhere.Clinical findings, ECG changes and troponin testing forms the mainstay of diagnosis.Many resource limited settings still use dated troponin assays.The aim of this study was to describe the diagnosis, prevalence and outcome of acute coronary syndrome at an urban, public emergency centre in Cape Town, South Africa where an older assay is in use. MethodsA retrospective, cross-sectional design was used to enrol participants.Comparisons were made between the diagnosis, outcome and troponin result (as per the Roche cardiac reader).Findings were presented as figures and proportions, and associations were tested using the Chi 2 -test. ResultsNine hundred and sixty-nine patients were included, from which 40 (4%) were excluded due to lack of clinical records.Two hundred and fifty-six patients were diagnosed with acute coronary syndrome, from which only 54 were troponin positive (Chi 2 = 22.1, p<0.001).However, 197 (76.9%) acute coronary syndrome diagnoses turned out to be unstable angina.

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