Epidemiological Aspect of ST-Segment Elevation Myocardial Infarction (STEMI) in Saint-Louis of Senegal

Abstract

Background: Cardiovascular Disease (CVD) has become the largest and most common cause of Non-Communicable Diseases (NCD) related deaths worldwide, accounting for more than 50%. In Senegal, a few studies done on the topic showed a low prevalence of acute coronary syndrome in hospital settings. In the city of Saint-Louis in Northern Senegal, there is little epidemiological data on Acute Coronary Syndrome (ACS) and no study specifically concerned with ST-segment Elevation Myocardial Infarction (STEMI) has been carried out to date. With this in mind, we conducted a study that focused on the analysis of STEMI patients hospitalized in the Cardiology Department of the Regional Hospital of Saint-Louis. The aim of our study was to collect and analyze the epidemiological aspect of STEMI. Results: There were 39 cases of STEMI, (i.e. 82.29% of ACS), giving a hospital prevalence of 8.21%. There was a slight male predominance with a male to female ratio of 1.05. The average age of our patients was 62.93 years ranging from 38 to 90 years. The average time between the onset of pain and arrival at the hospital was 50 hours, ranging from 1 hour to 720 hours. Patients received within the first 12 hours made up 66% (n = 26) of our population, among them, 80.76% (n = 21) (i.e. 53.84% of STEMIs) were able to benefit from thrombolysis. All thrombolysis was performed with Streptokinase. The mean time to thrombolysis was 6 hours ranging from 1 hour and 45 minutes to 11 hours. Arterial hypertension was the most frequent cardiovascular risk factor in our popular with a 43.6% prevalence, followed by diabetes (33.33%), then active smoking (23%). Chest pain was the most frequent symptom, reported in 34 patients (87.17%). The lesions on the Electrocardiogram (EKG) were located in the anterior territory in 64% of the cases (n = 25), in the inferior territory in 28% of the cases (n = 11), in the circumferential territory in 5% of the cases (n = 2), and lateral territory in 5% of the cases (n = 2). Twenty-five patients had a transthoracic echocardiogram, the left ventricular ejection fraction was preserved in 36% of the patients, 40% had moderate ventricular dysfunction and 24% had severe dysfunction. Segmental kinetic disorders of the left ventricle were noted in 18 patients (72%), akinesia in 7 patients (28%) and dyskinesia in 4 patients (16%). The average length of hospitalization was 8.43 days. Seven deaths (17.9%) were recorded during the study. Coronary angiography was performed in six patients (15.38%), and was abnormal in five cases. Conclusion: ST-segment Elevation Myocardial Infarctions remain a major public health issue in Senegal due to their increasing prevalence and poor prognosis due to delayed diagnosis and management.