Introduction: Acute coronary syndromes (ACS) represent the acute manifestation and most severe form of coronary artery disease; due to their varied complications, they remain the leading cause of mortality in developed countries.

The aim of our study was to analyze the various complications of ACS, highlighting their clinical impact, and their therapeutic management in the cardiology department of Ignace Deen Hospital in Conakry.

Materials and Methods: This was a prospective descriptive study lasting 06 months, from January 10 to July 10, 2023, in the cardiology department of Ignace Deen Hospital, Conakry; we included all patients admitted and hospitalized for coronary syndrome with at least one of its complications. Our study variables were quantitative and qualitative.

Results: During the study period, 92 cases of coronary syndrome were recorded, including 52 complicated cases (56.52%); the average age of our patients was 56.4 +/- 11 years; they were predominantly male, with a sex ratio of 2; arterial hypertension (n=46) and smoking (n=34) were the most common modifiable cardiovascular risk factors in 88.46% and 65.38% respectively; heart failure (n=36) and rhythm disorders (24) were the most frequent complications in 69.23% and 46.15% respectively; in terms of treatment, all patients benefited from medical therapy, 11 from thrombolysis (21.15%) and 07 from angioplasty (13.46%); there were 13 cases of death (25%).

Conclusion: Coronary syndromes are frequent in our context, resulting in a high rate of complications requiring rapid and appropriate management.