Acute Coronary Syndrome with Persistent ST-Segment Elevation: Epidemiological, Clinical, Paraclinical Features, and Management Modalities in Mauritania

Background: ST-Elevation Myocardial Infarction (STEMI), marked by manifestations linked to coronary atherosclerosis and sudden myocardial perfusion impairment, poses a significant global public health challenge due to its prevalence and lethality. In Mauritania, where the last study was conducted in 2017, Aim: this research aims to delineate the epidemiological, clinical, and paraclinical profiles of hospitalized STEMI patients and evaluate the management and short- term in-hospital outcomes. Materials and methods: The study, conducted at the National Cardiology Center in Nouakchott, Mauritania, from July to September 2022, is a single-center observational analysis focusing on STEMI management. Data from 86 patients were prospectively collected, encompassing sociodemographic, clinical, paraclinical, therapeutic, and short-term outcome variables. IBM SPSS 26 software was utilized for data analysis, employing statistical tests such as Student's t- test and Fisher's Chi-square test with a significance level set at p < 0.05. Results: Hospital prevalence of ST-Elevation Myocardial Infarction (STEMI) was 10.2%, predominantly affecting males (ratio 4.06) with a mean age of 56.5 years. Men had a higher cumulative cardiovascular risk burden and smoking prevalence, while women showed higher rates of diabetes and hypertension. Most patients sought medical attention within 12 hours, and revascularization was performed in 84% of cases, resulting in favorable outcomes in 78%, with complications observed in 22% and a 13% mortality rate during the acute phase. Conclusion: The management of STEMI in Mauritania has seen improvements, with increased rates of revascularization, notably primary angioplasty, rising from 5% to 36% in 5 years. However, the persistently high mortality rate stands at approximately 13%. Recommendations include strengthening primary prevention, anti-tobacco campaigns, ensuring emergency revascularization resources, and facilitating medical transport for timely treatment.