Abstract
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.
Highlights
Angola is an African country located in southern Africa, with a territorial extension of about 1,246,700km[2] and a population of approximately 35 million inhabitants.[1]
This increase may be explained by changes in lifestyle, rapid urbanization and conditions that lead to a fast epidemiological transition, bringing with them an increased prevalence of cardiovascular risk factors and higher morbidity and mortality rates from acute myocardium infarction (MI),[3] in a scenario in which difficult access to diagnostic and treatment services and lack of specialized professionals interfere in its greater notoriety
Our study included 165 patients of both sexes diagnosed with segment elevation MI (STEMI)
Summary
Angola is an African country located in southern Africa, with a territorial extension of about 1,246,700km[2] and a population of approximately 35 million inhabitants.[1] It is an epidemiological stage dominated by infectious diseases, where the incidence of coronary artery disease (CAD) has slowly increased, with drastic impacts on the population.[2] This increase may be explained by changes in lifestyle, rapid urbanization and conditions that lead to a fast epidemiological transition, bringing with them an increased prevalence of cardiovascular risk factors and higher morbidity and mortality rates from acute myocardium infarction (MI),[3] in a scenario in which difficult access to diagnostic and treatment services and lack of specialized professionals interfere in its greater notoriety This limits the real understanding of the disease, availability of better statistical data and, 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. By 2030, CAD will account for about 30 million deaths.[5]
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