Key result
Acute coronary syndromes in a sub-Saharan African hospital presented as STEMI in 56% of cases, with an overall mortality of 6% to 10% often due to late presentation.
Why the study?
What is the epidemiology, presentation, management, and outcome of acute coronary syndromes in an urban hospital in sub-Saharan Africa?
Observational (n=111)
No
What is the epidemiology, presentation, management, and outcome of acute coronary syndromes in an urban hospital in sub-Saharan Africa?
Acute coronary syndromes are increasingly prevalent in sub-Saharan Africa with risk profiles similar to the developed world, though late presentation frequently precludes reperfusion therapy and contributes to mortality.
Late presentation drives sub-Saharan ACS mortality; leaves open need for region-specific strategies and prospective trials.
OBJECTIVES: To determine the epidemiology of acute coronary syndromes (ACS) in sub-Saharan Africa. METHODS: A prospective survey was carried out of all patients with a diagnosis of ACS who were admitted to the critical care unit of a tertiary teaching hospital over a 25-month period. Demographics, presentation, management and outcomes were subsequently recorded. RESULTS: A total of 111 (5.1% of all hospitalisations) patients were recruited, with 56% presenting with ST-elevation myocardial infarction (STEMI) and the rest non-ST-elevation myocardial infarction (NSTEMI) or unstable angina (UA). Chest pain was the most common presenting symptom, and up to one-third of all STEMI patients did not receive any form of reperfusion therapy, primarily due to late presentation. As in the developed world, diabetes, hypertension and cigarette smoking still account for the most common predisposing risk-factor profile, and the mortality associated with ACS is about six to 10% in our unit. CONCLUSIONS: ACS, contrary to common belief, is increasingly more prevalent in sub-Saharan Africa, with similar risk profiles to that in the developed world. Late presentation to hospital is common and accounts for the increased mortality associated with this condition.
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Shavadia et al. (2012) conducted an observational in Acute coronary syndromes (n=111). Acute coronary syndromes was evaluated on Epidemiology, management, and outcomes. Acute coronary syndromes in a sub-Saharan African hospital presented as STEMI in 56% of cases, with an overall mortality of 6% to 10% often due to late presentation.
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