Background

In recent years, there has been an increase in the use of percutaneous coronary intervention (PCI) across the African continent. This review aims to evaluate and report the clinical outcomes of PCI use in African among patients with coronary heart disease.

Methods

A comprehensive search was conducted on PubMed, EMBASE via Ovid, and AJOL. The Preferred reporting items for systematic reviews and meta-analysis (PRISMA) guideline was used in this study. Articles were screened according to a predefined eligibility criteria. The Primary outcomes assessed were all-cause mortality and major adverse cardiovascular events (MACE). Secondary outcomes included post-procedural outcomes like complications and post-procedure TIMI flow grade.

Results

This review synthesized 31 articles from nine African countries. A total of 11,507 patients participated in this study, and 10,701 patients underwent PCI procedures with stenting being the most common technique employed. 74.3% of patients were male. A total of 170(17.8%) MACE cases were reported, and an overall mortality of 457(4.9%) was reported - in-hospital mortality was reported among 4.7% of the assessed patients. About 78.2% of patients who underwent PCI achieved post-procedure TIMI flow grade III - an indicator of reperfusion success rate in the study. The most common complications reported include: Heart failure (19.1%), arrhythmia (9.1%), revascularization (8.9%), coronary events (8.1%), structural complications (8.1%), and the need for ICU support (7.9%).

Conclusion

The study shows higher mortality and complication rates when compared to more developed countries. The high burden of comorbidities paired with complication rates reflects systemic gaps in both acute and chronic cardiovascular care. Marked geographic imbalances and limited long-term follow-up constrain the generalizability of findings and emphasizes the urgent need for investment in national and regional PCI registries, equitable expansion of interventional cardiology infrastructure, and integration of PCI data into broader non-communicable disease surveillance frameworks.