Acute coronary syndromes in Ivory Coast: About 1011 cases

Abstract

Acute coronary syndromes (ACS) are emerging in developing countries, particularly in sub-Saharan Africa. Assess prevalence, characteristics and management of acute coronary syndromes in Ivory Coast. Cross sectional study from January, 2002 to December, 2016, carried out among patients aged 18 years old, admitted to intensive care unit of Abidjan Heart Institute for ACS. One thousand and eleven (1011) patients were enrolled in this study. Prevalence of ACS was 14.9% (1011/6784). Mean age was 55.0 ± 11.4 years. Main cardiovascular risk factor was hypertension (57.8%). Mean delay between symptom onset and admission to Abidjan heart institute was 35.0 ± 37.8 hours. Clinical presentation was predominantly ST-segment elevation myocardial infarction (STEMI) in 74.5% of subjects. Seven hundred and five patients (69.5%) were transferred by unsafe transportation. Among the 214 patients admitted for STEMI within 12 hours of the onset of symptoms, primary percutaneous coronary intervention was performed in 42 patients (19.6%), or 5.5% of STEMI as a whole. Seventy-eight patients (10.3%) received fibrinolytic therapy. In-hospital death rate was 8.9%. The prevalence of acute coronary syndromes is increasing in sub-Saharan Africa. Management remains challenging in our regions, because of excessive delays of admission and limited technical facilities.