DOI: https://doi.org/10.36347/sasjm.2026.v12i10.007

Pages: 1045-1055

Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) requires timely diagnosis and treatment, yet Moroccan data on delayed hospital presentation remain limited. This retrospective, observational, single-center study included 120 consecutive adults with NSTE-ACS who underwent coronary angiography at Ibn Sina University Hospital in Rabat between January 2024 and May 2026. Prolonged prehospital delay was defined as a symptom-to-door time of more than 24 hours, and associated factors were identified using multivariable logistic regression. Left ventricular functional recovery was assessed by the change in left ventricular ejection fraction (LVEF) from baseline to three months. Median symptom-to-door time was 24 hours [IQR, 12-72], and 54 patients (45.0%) presented more than 24 hours after symptom onset. Median door-to-angiography time was 24 hours [IQR, 24-72], and median symptom-to-angiography time was 73 hours [IQR, 48-144]. Greater distance from the tertiary care center (OR, 1.009; 95% CI, 1.001-1.017), an abnormal ECG (OR, 3.957; 95% CI, 1.203-13.013), lower admission troponin levels (OR, 0.934; 95% CI, 0.873-0.998), and lower baseline LVEF (OR, 0.959; 95% CI, 0.924-0.994) were independently associated with prolonged prehospital delay. Among 31 patients assessed at three months, median LVEF increased from 55% to 58% (p=0.003), but recovery was not significantly associated with prehospital delay. Prolonged prehospital delay was common and was related to both patient- and healthcare system-related factors. Improving symptom recognition, access to medical care, and regional referral pathways may help reduce delayed presentation.