Sex Differences in Clinical and Angiographic Characteristics in Acute Coronary Syndrome Patients in Dakar, Senegal

Abstract

Background: Coronary artery disease (CAD) is in relentless progression, along with the adoption of western lifestyle in sub-Saharan Africa. In Senegal, the incidence of acute coronary syndrome (ACS) rose from 5% to 12% in Dakar during the last 20 years. That increase was observed in both women and men, and according to current data, the former paid the heaviest price in terms of mortality compared to men. In this study, we aim to retrospectively assess the clinical characteristics and angiographic profile of ACS in women compared to men in two tertiary care centers in Dakar. Methods: In this study, we retrospectively analyzed and compared data between men and women among 133 patients who underwent coronary angiogram for ACS in 2 tertiary centers from February 2019 to January 2020. Results: A total of 133 patients were included in our study of whom 97 (72.9%) were men. The mean age was 58 ± 13.6 years. Women were older than men (61.4 ± 14.3 years vs 56.6 ± 13.5 years (p = 0.07). Hypertension, sedentary lifestyle and obesity were significantly more frequent in women (69.4%, 52.7% and 19.4%) when compared to men (38.8%, 25.7% and 6.19%) respectively, (p = 0.001; 0.002 and 0.03). Smoking was less frequent in women (2.8%) than in men (44.3%), (p < 0.001). The mean time from diagnosis to coronary angiography was not statistically different regardless of the presentation mode. On coronary angiogram, single vessel disease was most common (36.1% of men vs 33.3% of women) followed by triple vessel disease (24.7% vs 19.4% respectively). The left anterior descending artery was the most commonly affected vessel (84.4% of men vs. 61.1% of women) in both sexes followed by the left circumflex artery. The left main stem was diseased similarly in both sexes (around 8%). The majority of patients had low SYNTAX score but more often women than men (97.2% vs 92.78%, p = 0.04). Among all the patients, 65 (48.9%) underwent PCI with no statistical difference between men and women. Conclusion: In our study,

Coronary Angiography and Interventions in a Sub-Saharan African Country: A 6-year Retrospective Review at Korle-Bu Teaching Hospital.

“…A retrospective analysis of the angiographic pro le of ACS patients in two tertiary care centers in Dakar, Senegal, described single vessel disease as the most common, followed by triple vessel disease. 25 In-hospital outcomes study, the in-hospital mortality was 1.3%, with a higher incidence (6.6%) of periprocedural death in emergency cases than in elective cases (0.3%). Based on a systematic review of ACS in sub-Saharan Africa, in-hospital mortality was found to be variable, ranging from 1.2-24.5%, and primarily in uenced by the study populations and revascularization procedures performed.…”