Background: In Central Africa, data on the management of Acute Coronary Syndrome (ACS) remain scarce, particularly regarding comprehensive care within a cardiac catheterization laboratory.

Objective: To describe the epidemiological, angiographic, and therapeutic characteristics of patients managed for Acute Coronary Syndrome (ACS) at a cardiac catheterization unit in Cameroon, and to identify associated factors.

Methods: A descriptive and analytical cross-sectional observational study was conducted over a three-year period (November 2022– November 2025) at the Yaoundé General Hospital. Data were retrieved from the DéRICA registry. The study included all consecutive patients admitted for ACS with significant coronary lesions (≥50%) who underwent percutaneous coronary intervention (PCI).

Results: Among 115 patients admitted to the catheterization laboratory, 69 presented with ACS. The mean age was 56,97 ±11,69years, with a marked male predominance. Hypertension, diabetes, and dyslipidemia were highly prevalent. Elevated lipoprotein(a) was associated with ACS after adjustment (p adjusted = 0.039). Impaired left ventricular ejection fraction (LVEF < 50%) was significantly more frequent among STEMI patients. Most ACS patients sought medical attention within a timeframe of 1 to 30 days. Lesions of the left anterior descending (LAD) artery were significantly associated with ACS (aOR = 6,91). The severity of lesions according to the ACC/ AHA classification did not differ significantly between the groups. As far as management is concerned, 39,2% patients presenting with STEMI underwent PCI with drug eluting stenting while 3,9% experienced CABG.

Conclusion: Our findings underscore the urgent need to enhance screening, facilitate access to coronary angiography and angioplasty, and expand interventional cardiology capacity.