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While the management quality measures and clinical outcomes of patients with ACS have been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So, this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients with ACS in Ethiopia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A\u00a0Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018 to November 2018.\u00a0The primary outcome of the study was in-hospital mortality. Data were\u00a0analyzed using SPSS version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality. Variable with <jats:italic>p<\/jats:italic> -value &lt;\u20090.05 was considered statistically significant.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction (STEMI). The mean age of the study participant was 55.8\u2009\u00b1\u200911.9\u2009years and 62.4% were males. The use of guideline-directed medications within 24\u2009h of hospitalization were\u00a0sub-optimal (57%) [Dual antiplatelet (73%), statin (74%), beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the\u00a0percutaneous coronary intervention (PCI). Discharge aspirin and statin were\u00a0high (&gt;\u200990%) while other medications were sub-optimal (&lt;\u200980%). The\u00a0all-cause in-hospital mortality rate was 20.4% and the\u00a0non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81\u20137.29), symptom onset to hospital arrival &gt;\u200912\u2009h (AHR: 4.23, 95% CI: 1.28\u201313.81), and Cardiogenic shock (AHR: 7.20, 95% CI: 3.55\u201314.55) were independent predictors\u00a0of time to in-hospital death among ACS patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In the present study, the use of guideline-directed in-hospital medications was sub-optimal. The\u00a0overall in-hospital mortality rate was\u00a0unacceptably high and highlights the urgent need for national quality-improvement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to reduce pre-hospital delay.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12873-021-00433-3","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T09:02:43Z","timestamp":1617181363000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Management quality indicators and in-hospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study"],"prefix":"10.1186","volume":"21","author":[{"given":"Korinan","family":"Fanta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fekede Bekele","family":"Daba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsah","family":"Tegene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsegaye","family":"Melaku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginenus","family":"Fekadu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Legese","family":"Chelkeba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"issue":"1","key":"433_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jacc.2017.04.052","volume":"70","author":"GA Roth","year":"2017","unstructured":"Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. 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Permission was obtained from responsible bodies of respective hospitals before interviewing patients and extracting data from active patient\u2019s case records. Written and verbal informed consent was obtained from all study participants. All the study protocols were performed in accordance with the ethical principles of the Declaration of Helsinki []. The confidentiality and privacy of participant's data were\u00a0maintained by using different codes throughout the data collection tools.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare that there is no competing of interest regarding this work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"41"}}