Primary PCI in the management of STEMI in sub-Saharan Africa: insights from Abidjan Heart Institute catheterisation laboratory

Ekou, A.; Yao, Hermann; Kouamé, Innocent Kouassi; Boni, Rolande Yao; Ehouman, Esther; N’Guetta, Roland

doi:10.5830/cvja-2020-012

Cited by 11 publications

(19 citation statements)

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“…16 In another African study, CAD was observed in 56% of patients with infarction treated by PCI. 4 In Angola, there are few epide-miological data to compare with this finding, but it may be inferred they would be similar to those reported in other parts of the world. 4,10,15,17 The femoral approach was preferably used (75.8%), followed by transradial access (23.6%).…”

Section: Discussionsupporting

confidence: 74%

“…4 In Angola, there are few epide-miological data to compare with this finding, but it may be inferred they would be similar to those reported in other parts of the world. 4,10,15,17 The femoral approach was preferably used (75.8%), followed by transradial access (23.6%). Similar data were published in a study carried out in Côte d'Ivoire, in which most patients undergoing PCI were approached via the femoral route.…”

Section: Discussionsupporting

confidence: 74%

“…6,9,10 There was a predominance of male individuals treated by PCI, especially those in full active and productive phase of life, and hypertension stood out significantly as the most important risk factor. This data does not differ from the reality of other African countries, 3,4,6,8 which show a strong association between risk factors and the occurrence of acute MI. 11,12 In Angola, several publications on the topic of risk factors are unanimous in highlighting hypertension as the main one, especially in individuals of lower socioeconomic status, and its association with smoking, DM, alcoholism and dyslipidemia could explain the higher prevalence and, consequently, the gradual increase in the incidence of acute MI in Angola.…”

Section: Discussioncontrasting

confidence: 45%

“…On the other hand, divergent data from African studies conducted in patients with acute MI, treated by PCI, revealed most patients had involvement of the inferior wall. 4,15 Single-vessel CAD was the most prevalent angiographic characteristic, with no significant difference regarding sex (38.2% versus 12.7%; p=0.99). A South African study reported most patients had multivessel disease (42%) and the incidence of single vessel injury was 36%.…”

Section: Discussionmentioning

confidence: 91%

“…This limits the real understanding of the disease, availability of better statistical data and, consequently, the creation of specific health policies. 3,4 Coronary artery disease accounts for about 18 million deaths in the world annually, and 80% of these deaths occur in low-and middle-income countries. It is estimated that, by 2030, CAD will account for about 30 million deaths.…”

Section: Introductionmentioning

confidence: 99%

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Primary angioplasty in acute myocardial infarction: initial experience in a developing country

Vicente¹,

Dopico²,

Domingos³

et al. 2021

J Transcat Intervent

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Background: Coronary artery disease is a major public health concern worldwide. In Africa, varying rates of progression increased in different countries. In Angola, although the epidemiological scenario is dominated by infectious diseases, the prevalence of coronary artery disease is increasing with notable impacts, requiring the creation of mechanisms to face this reality in a country where lack of specific infrastructure is still a challenge. The objective of this study was to describe the experience of primary angioplasty in patients with acute myocardial infarction in an Angolan tertiary care center. Methods: This was a descriptive, longitudinal, retrospective study, involving 165 patients diagnosed with acute myocardial infarction between 2012 and 2019. Variables were age, sex, risk factors, angiographic and procedure-related characteristics, and main complications. Results: The mean age was 58.3±6.8 years, and males predominated (75.8%). Hypertension (69.7%), dyslipidemia (35.2%), smoking (32.7%) and diabetes (29.7%) were more prevalent. The anterior location was the predominant topography of infarction (49.7%). Single vessel disease was the most common pattern (50.9 %). The left anterior descending artery was the most often involved vessel (49.7%). The door-to-balloon time was 46.6±32.4 minutes. In the multivariate analysis, anterior myocardial infarction (p=0.033), diabetes (p=0.004), age ≥60 years (p≤0.001) and post-coronary intervention final TIMI flow Conclusion: Percutaneous coronary intervention in the context of acute myocardial infarction in Angola is a reality, but the number of procedures performed is not enough given the current great demand.

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