Abstract
BackgroundCoronary heart disease remains the leading cause of death in developed countries. In Africa, the disease continues to rise with varying rates of progression in different countries. At present, there is little available work on its juvenile forms. The objective of this work was to study the epidemiological, clinical and evolutionary aspects of acute coronary syndrome in young Sub-Saharan Africans.MethodsThis was a prospective multicenter study done at the different departments of cardiology in Dakar. We included all patients of age 40 years and below, and who were admitted for acute coronary syndrome between January 1st, 2005 and July 31st, 2007. We collected and analyzed the epidemiological, clinical, paraclinical and evolutionary data of the patients.ResultsHospital prevalence of acute coronary syndrome in young people was 0.45% (21/4627) which represented 6.8% of all cases of acute coronary syndrome admitted during the same period. There was a strong male predominance with a sex-ratio (M:F) of 6. The mean age of patients was 34 ± 1.9 years (range of 24 and 40 years). The main risk factor was smoking, found in 52.4% of cases and the most common presenting symptom was chest pain found in 95.2% of patients. The average time delay before medical care was 14.5 hours. Diagnosis of ST- elevation myocardial infarction in 85.7% of patients and non-ST-elevation myocardial infarction in 14.3% was made by the combination electrocardiographic features and troponin assay. Echocardiography found a decreased left ventricular systolic function in 37.5% of the patients and intraventricular thrombus in 20% of them. Thrombolysis using streptokinase was done in 44.4% of the patients with ST- elevation myocardial infarction. Hospital mortality was 14.3%.ConclusionAcute coronary syndrome is present in young Sub-Saharan Africans. The main risk factor found was smoking.
Highlights
Coronary heart disease remains the leading cause of death in developed countries
(21/309) of patients admitted for acute coronary syndrome during the same period
The risk factors in our patients (Table 1) were dominated by active smoking found in 11 patients (52.4%)
Summary
Coronary heart disease remains the leading cause of death in developed countries. In Africa, the disease continues to rise with varying rates of progression in different countries. The objective of this work was to study the epidemiological, clinical and evolutionary aspects of acute coronary syndrome in young Sub-Saharan Africans. Coronary heart disease remains the leading cause of death in developed countries. It is usually seen from the fifth to the seventh decades of life, but some cases in young people have been reported [1,2]. The objective of this work was to study the epidemiological, as well as the clinical and evolutionary peculiarities of acute coronary syndrome (ACS) in the young Sub-Saharan Africans of age 40 years and below.
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