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Yao H, Ekou A, Ehouman E, Guezo M, Soya E, Kouadio D, Touré C, Kipenge R, Koffi D, N'Guetta R. [Cardiovascular risk assessment among patients with hypertension based on SCORE2 and SCORE-OP algorithms in black Africans]. Ann Cardiol Angeiol (Paris) 2023; 72:101602. [PMID: 37187110 DOI: 10.1016/j.ancard.2023.101602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Hypertension is a major risk factor for cardiovascular events. The cardiovascular risk assessment is performed using specific algorithms, particularly SCORE2 and SCORE2-OP developed by the European Society of Cardiology. PATIENTS AND METHODS Prospective cohort study from February 1, 2022, to July 31, 2022, enrolling 410 hypertensive patients. Epidemiological, paraclinical, therapeutic, and follow-up data were analyzed. Cardiovascular risk stratification of patients was performed using SCORE2 and SCORE2-OP algorithms. We compared the initial and 6-month cardiovascular risks. RESULTS The mean age of the patients was 60.88 ± 12.35 years with a female predominance (sex ratio = 0.66). In addition to hypertension, dyslipidemia (45.4%) was the most frequently associated risk factor. A high proportion of patients were classified as high (48.6%) and very high (46.3%) cardiovascular risk, with a significant difference between men and women. Reassessment of cardiovascular risk after 6 months of treatment found significant differences compared with the initial cardiovascular risk (p < 0.001). The rate of patients at low to moderate cardiovascular risk (49.5%) increased substantially, whereas the proportion of patients at very high risk decreased (6.8%). CONCLUSION Our study conducted at Abidjan Heart Institute in a young population of patients with hypertension revealed a severe cardiovascular risk profile. Almost half of the patients are classified at very high cardiovascular risk, based on the SCORE2 and SCORE2-OP. The widespread use of these new algorithms for risk stratification should lead to more aggressive management and prevention strategies for hypertension and associated risk factors.
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Affiliation(s)
- H Yao
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - A Ekou
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - E Ehouman
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - M Guezo
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - E Soya
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - D Kouadio
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - C Touré
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - R Kipenge
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - D Koffi
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - R N'Guetta
- Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
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Limbole E, Mipinda JB, Cavagna P, Hermann Y, Tchuem Tchuente-Noutchogouin M, Souleymane C, Asselin A, Mbaye A, Kamdem F, Sidy Ali A, Thiam S, N'da N'kenon Watani J, Antignac M, N'Guetta R, Jouven X. Stroke care in 17 Sub-Saharan African countries: the FEBRUARY study (2016–2021) from African research network. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Stroke is one of the leading causes of morbidity and mortality worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disability would occur in low- and middle-income countries. Between 2002 and 2020, estimation stroke mortality in Sub-Saharan Africa (SSA) was tripled. There is scarce data on management of stroke in SSA.
Purpose
To describe stroke care in cardiology departments in 17 SSA countries
Methods
We conducted a transversal and longitudinal study in CV department of 37 hospitals from 23 cities in 17 SSA countries (10 low income: Niger, Guinea, Benin, Mali, Democratic Republic of the Congo (DCR), Tchad, Burkina Faso, Togo, Burundi, Ethiopia and 7 middle income: Cote d'Ivoire, Senegal, Cameroon, Congo, Soudan, Mauritania, Gabon). The FEBRUARY study was designed by a multidisciplinary collaborative team of epidemiologists, pharmacists and cardiologists from Africa and France. This ongoing observatory included all inpatients in February from each year since 2016. Data including socio-demographic and clinical characteristics, causes of admission, clinical, biological, complementary examinations, treatments, length of stay and discharge diagnosis were collected by the investigating physicians. All analyses were performed through scripts developed in the R software (4.0.3 (2020-10-10)).
Results
Overall, 4360 patients were admitted to hospital over the 6 years of the study. Stroke was the third cause of hospitalization with 477 (11%) patients admitted. Proportions of patients admitted for stroke varied across countries from 0% in Ethiopia to 52% in DRC (p<0.01) (figure) and over the years from 11% in 2016 to 16.5% in 2021. Men represented 60.1% of stroke patients. Mean of age was 62.5±13.4 years. Overall, 300 patients (62.9%) were from low-income countries and 177 patients (37.1%) from middle-income countries. A majority of patients were living in urban areas (N=387; 82.9%) compared to rural areas (N=80; 17.1%). Individual wealth index was low, middle and high in 105 (23.2%), 152 (33.6%) and 196 (43.3%) patients respectively. Among stroke patients, 413 (89.8%) had a computed tomography. Ischemic stroke represented 71.8% of patients with stroke. Among CV risk factors, high blood pressure was identified in 81.9% of patients. In-hospital antithrombotic therapy was prescribed for 2 patients (0.42%). Anticoagulant therapy and antiplatelet therapy were prescribed for 26.4% and 53.5% of patients respectively. Proportions of patients treated with antiplatelet therapy varied across countries (p<0.05). At discharge, 8% and 44.4% of patients received anticoagulant therapy or antiplatelet therapy respectively. Mean of length of stay was 12.4±18.4 days. Stroke represent the second cause of mortality (18.7%) and did not vary significantly across countries.
Conclusion
Stroke was the third cause of admission with more than 1/10 patients and the second cause of mortality with almost 1/5 patients in cardiology departments in SSA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Limbole
- Ngaliema Hospital , Kinshasa , Congo (Democratic Republic of the)
| | - J B Mipinda
- University hospital, Cardiology , Libreville , Gabon
| | - P Cavagna
- Pitie Salpetriere APHP University Hospital, Pharmacy , Paris , France
| | - Y Hermann
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | | | - C Souleymane
- Point G university hospital center , Bamako , Mali
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - A Mbaye
- Grand Yoff General Hospital , Mdakar , Senegal
| | - F Kamdem
- Douala General Hospital , Douala , Cameroon
| | - A Sidy Ali
- Centre National de Cardiologie, Cardiology , Nouakchott , Mauritania
| | - S Thiam
- El Hadji-Ibrahima Niass Hospital, Cardiology , Kaolac , Senegal
| | | | - M Antignac
- Pitie Salpetriere APHP University Hospital, Pharmacy , Paris , France
| | - R N'Guetta
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | - X Jouven
- European Georges Pompidou Hospital, AP-HP Centre, University of Paris, Cardiology , Paris , France
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Ali Toure I, Traore AK, Cavagna P, Damorou JM, Diao M, Dzudie A, N'Guetta R, Kouam Kouam C, Hermann Y, Limbole E, Gaye B, Toure C, Yameogo V, Jouven X, Antignac M. Causes of admission and mortality among patients admitted in 37 cardiology departments in 17 Sub-Saharan African countries: the FEBRUARY observatory (2016–2021) from African Research Network. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiovascular disease (CVD) is a major cause of death worldwide. At least two-third of CVD death occurs in low- (LIC) and middle-income (MIC) countries. An estimated 1 million deaths were attributable to CVD in sub-Saharan Africa (SSA) alone. Scarce data are available about the admission for CVD and outcome in cardiology department in SSA.
Purpose
To describe admission for CVD and outcome of hospitalization in 17 in SSA countries.
Methods
We conducted a transversal and longitudinal study in CV department of 37 hospitals from 23 cities in 17 SSA countries (10 low income: Niger, Guinea, Benin, Mali, Democratic Republic of the Congo, Tchad, Burkina Faso, Togo, Burundi, Ethiopia and 7 middle income: Cote d'Ivoire, Senegal, Cameroon, Congo, Soudan, Mauritania, Gabon). The February study was designed by a multidisciplinary collaborative team of epidemiologists, pharmacists and cardiologists from Africa and France. This ongoing observatory included all inpatients in February from each year since 2016.Data including socio-demographic and clinical characteristics, causes of admission, clinical, biological, complementary examinations, treatments, length of stay and discharge diagnosis were collected by the investigating physicians. All analyses were performed through scripts developed in the R software (4.0.3 (2020-10-10))
Results
Overall, 4360 patients were included in the February study. Men represented 56.4%. Mean of age was 56.7±16.8 years. The main cause of admission was heart failure (41.5%) followed by acute coronary syndrome (11.9%) and stroke (11%). Cause of admission varied significantly across countries (p<0.01) and over the years (p<0.01). Proportions of admission for heart failure varied from 20% in Ethiopia to 62% in Guinea. Mean of length of stay was 9.95±22.4 days. All causes of admission confounded, in-hospital mortality rate was 11% (N=423). Mortality rate differed significantly according to causes of admission (p<0.01).Mortality rate among patients admitted for stroke, heart failure and acute coronary syndrome was respectively 18%, 12.3% and 9.5%. Overall, 31 (0.7%) were admitted for endocarditis and mortality rate among them was 20.8% (figure). Overall, mortality rate did not vary according to gender or over the years but was significantly different according to patient wealth index (p<0.05), countries (p<0.01) and level income countries (p<0.01). Mortality rate was significantly higher in LIC.
Conclusion
Heart failure, acute coronary syndrome and stroke represent the two-third of causes of admission. Overall, mortality rate in cardiology departments in SSA reached 11%.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- I Ali Toure
- Amirou Boubacar Diallo Hospital, Internal Medicine and Cardiology , Niamey , Niger
| | - A K Traore
- Hospital of Sikasso, Cardiology , Sikasso , Mali
| | - P Cavagna
- Pitie Salpetriere APHP University Hospital, Pharmacy , Paris , France
| | - J M Damorou
- Campus Teaching Hospital, Cardiology , Lome , Togo
| | - M Diao
- Aristide Le Dantec Hospital, Cardiology , Dakar , Senegal
| | - A Dzudie
- Douala General Hospital , Douala , Cameroon
| | - R N'Guetta
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | - C Kouam Kouam
- Regional Hospital of Bafoussam , Bafoussam , Cameroon
| | - Y Hermann
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | - E Limbole
- Ngaliema Hospital, Cardiology , Kinshasa , Congo (Democratic Republic of the)
| | - B Gaye
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - C Toure
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | - V Yameogo
- University Hospital of Yalgado Ouédraogo , Ouagadougou , Burkina Faso
| | - X Jouven
- European Georges Pompidou Hospital, AP-HP Centre, University of Paris , Paris , France
| | - M Antignac
- Pitie Salpetriere APHP University Hospital, Pharmacy , Paris , France
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Yao H, Ekou A, Brou I, Niamkey T, Koffi F, Tano S, Kouamé I, N'Guetta R. [Evolution of epidemiology and management of acute coronary syndromes in Abidjan : A cross-sectional study of 1011 patients.]. Ann Cardiol Angeiol (Paris) 2022; 71:130-135. [PMID: 35293317 DOI: 10.1016/j.ancard.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 11/29/2020] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND To assess the evolution of the epidemiology and management of patients hospitalized to Abidjan Heart Institute for acute coronary syndrome (ACS). METHODS Cross-sectional study comparing two periods: from January 2002 to December 2009 (period 1) and from January 2010 to December 2016 (period 2), including all patients aged 18 years old, admitted to Intensive Care Unit of Abidjan Heart Institute for ACS. RESULTS One thousand eleven (1011) patients were included among the 6784 patients admitted to Intensive Care Unit of Abidjan Heart Institute for a cardiovascular disease. The overall prevalence of ACS was 14.9%. The prevalence in period 2 was significantly higher than in period 1 (22.6% and 7.3% respectively, p < 0.001). Diabetes (33.5%, p < 0.001) significantly, and smoking (30.7%, p = 0.30) had the largest rises from period 1 to period 2. ST-segment Elevation Myocardial Infarction was the main clinical presentation during both periods. The median time to treatment (p = 0.46) and length of hospital stay (p <0.001) decreased during period 2. Percutaneous coronary intervention (PCI) was performed in 173 patients (22.6%) during the period 2 and 42 patients (5.5%) underwent primary PCI. The rate of fibrinolysis increased significantly between the two periods (9.5%, p <0.001). In-hospital death increased during period 2 (10.4%, p = 0.07). CONCLUSION The burden of ACS and its related mortality have risen alarmingly past years in Côte d'Ivoire. Healthcare policies should help improve the management and outcomes of patients.
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Affiliation(s)
- H Yao
- Unité de Soins Intensifs Cardiologiques, Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - A Ekou
- Unité de Soins Intensifs Cardiologiques, Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - I Brou
- Laboratoire de biostatistique et d'informatique médicale, Centre Hospitalier Universitaire de Cocody, Abidjan, Côte d'Ivoire
| | - T Niamkey
- Service des explorations externes, Institut de Cardiologie d'Abidjan, Côte d'Ivoire
| | - F Koffi
- Service des Urgences, Institut de Cardiologie d'Abidjan, Côte d'Ivoire
| | - S Tano
- Unité de Soins Intensifs Cardiologiques, Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - I Kouamé
- Unité de Soins Intensifs Cardiologiques, Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - R N'Guetta
- Unité de Soins Intensifs Cardiologiques, Institut de Cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire.
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Niamkey JT, Yao H, Matanga J, Ekou A, Kouamé I, N'Guetta R. [Assessment of peripheral artery disease in proven coronary patients in Abidjan Heart Institute of Côte d'Ivoire]. Ann Cardiol Angeiol (Paris) 2020; 70:13-17. [PMID: 32950211 DOI: 10.1016/j.ancard.2020.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/21/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Coronary artery disease is mainly due to atherosclerosis. The aim of this study was to evaluate the frequency of peripheral arterial disease in proven coronary artery disease and to determine the associated factors in our context. MATERIAL AND METHODS We included in a cross-sectional descriptive and analytical study 224 patients with proven coronary artery disease confirmed on coronary angiography from March 1 to October 30, 2019. It took place in the external exploration department of the Abidjan Heart Institute. An ultrasonographic exploration of the supra-aortic trunks and arteries of the lower extremity with measurement of the ankle brachial index (ABI) was carried out. RESULTS The mean age was 57.4±10.9 years (27-81years). There was a clear male predominance with a sex-ratio of 5. The prevalence of carotid artery disease was 56.4% of patients. The main factors associated with elevated Intima Media Thickness (IMT) and the presence of carotid plaques were male sex (OR=8.8; P=0.038), smoking (OR=2.5; P=0.049) and multi-truncular involvement (OR=3.2; P=0.014). In the lower extremities, there was a prevalence of peripheral arterial disease of 48.5%. The main factors associated with the decrease of ABI were age ≥50 years (OR=2.6; P=0.043), diabetes (OR=2.8; P=0.02), dyslipidemia (OR=3.8; P=0.001) and pluri-truncular involvement (OR=4.5; P<0.0001). CONCLUSION The presence of significant coronary artery disease in our context is associated with a high prevalence of peripheral carotid artery and lower extremity artery disease. This is all the more so as we are male, over 50 years old, pluri-truncular with many cardiovascular risk factors.
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Affiliation(s)
- J T Niamkey
- Service des explorations externes de l'Institut de cardiologie d'Abidjan, BPV 206 Abidjan, Côte d'Ivoire.
| | - H Yao
- Service des soins intensifs et de cardiologie interventionnelle de l'Institut de cardiologie d'Abidjan, BPV 206 Abidjan, Côte d'Ivoire
| | - J Matanga
- Service des explorations externes de l'Institut de cardiologie d'Abidjan, BPV 206 Abidjan, Côte d'Ivoire
| | - A Ekou
- Service des soins intensifs et de cardiologie interventionnelle de l'Institut de cardiologie d'Abidjan, BPV 206 Abidjan, Côte d'Ivoire
| | - I Kouamé
- Service des soins intensifs et de cardiologie interventionnelle de l'Institut de cardiologie d'Abidjan, BPV 206 Abidjan, Côte d'Ivoire
| | - R N'Guetta
- Service des soins intensifs et de cardiologie interventionnelle de l'Institut de cardiologie d'Abidjan, BPV 206 Abidjan, Côte d'Ivoire
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Gueniat-Ratheau E, Yao H, Debeaumarche H, Maalem B, Lairet C, Maza M, Bichat F, Zeller M, N'Guetta R, Cottin Y. [Prognostic value of HbA1c and plasma glucose on one-year mortality in non-diabetic patients after myocardial infarction]. Ann Cardiol Angeiol (Paris) 2020; 69:180-191. [PMID: 32854906 DOI: 10.1016/j.ancard.2020.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/30/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The usefulness of the combined assessment of HbA1c and plasma glucose (PG) in acute myocardial infarction (AMI) in non-diabetic patients remains unclear. PURPOSE In a large observational study, we aimed to identify the prognostic values of these biomarkers regarding one-year all-cause mortality in non-diabetic patients after AMI. METHODS From the "obseRvatoire des Infarctus de Côte d'Or" (RICO) survey database, we included all consecutive non-diabetic patients with AMI (n=6617) from May 2001 to December 2016. Exclusion criteria were: admission known or unknown diabetes, in-hospital death. The primary endpoint was all-cause one-year mortality. The secondary endpoints were: MACE, infarct size, LVEF<40% and GRACE risk score. Cut-off levels (high/low) were determined by ROC curve analysis for the prediction of one-year death (HbA1c 5.9% and PG 131mg/dL) to set up 4 groups: low HbA1c/low glucose (n=3158), low HbA1c/high glucose (n=1264), high HbA1c/low glucose (n=1378) and high HbA1c/high glucose (n=817). RESULTS Elevation of PG was associated with elevated rate of LVEF<40%, STEMI, anterior wall location, DFG<60mL/min/m2 and higher troponin Ic pic (all P<0.001); HbA1c>5.9% was associated with elevated rate of CRP>3mg/L (P<0.001); high HbA1c and high PG together were associated with higher rate of MACE (P<0.001). By multivariate logistic regression analysis, elevated admission PG remained a strong predictor of one-year all-cause [OR (95%CI): 1.64 (1.31-2.05)] mortality and cardiovascular mortality [OR (95%CI): 1.75 (1.33-2.31)], beyond GRACE score [OR (95%CI): 1.03 (1.03-1.04)], as well as elevated HbA1c [OR (95%CI): 1.43 (1.15-1.78) and OR (95%CI): 1.83 (1.39-2.41) respectively]. CONCLUSIONS Admission PG and HbA1c had strong independent predictive value regarding one-year all-cause mortality in our non-diabetic patients with AMI. These biomarkers could be useful to identify the most-at-risk patients after AMI in order to reduce residual risk in this target population.
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Affiliation(s)
| | - H Yao
- Cardiology department, institut de cardiologie, 01 BP V 2062, Abidjan, Côte d'Ivoire
| | | | - B Maalem
- Cardiology department, CHU de Dijon, Dijon, France
| | - C Lairet
- Cardiology department, CHU de Dijon, Dijon, France
| | - M Maza
- Cardiology department, CHU de Dijon, Dijon, France; Laboratory of cardiometabolic physiopathology and pharmacology, Inserm U866, University of Burgundy, Dijon, France
| | - F Bichat
- Cardiology department, CHU de Dijon, Dijon, France; Laboratory of cardiometabolic physiopathology and pharmacology, Inserm U866, University of Burgundy, Dijon, France
| | - M Zeller
- Cardiology department, CHU de Dijon, Dijon, France; Laboratory of cardiometabolic physiopathology and pharmacology, Inserm U866, University of Burgundy, Dijon, France
| | - R N'Guetta
- Cardiology department, institut de cardiologie, 01 BP V 2062, Abidjan, Côte d'Ivoire
| | - Y Cottin
- Cardiology department, CHU de Dijon, Dijon, France.
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Yao H, Ekou A, N'Djessan JJ, Zoumenou A, Angoran I, N'Guetta R. [Spontaneous coronary artery dissection: An exceptional cause of acute coronary syndrome]. J Med Vasc 2018; 43:52-55. [PMID: 29425541 DOI: 10.1016/j.jdmv.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/12/2017] [Indexed: 06/08/2023]
Abstract
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) or sudden death, which typically affects young women. We reported two cases of black Africans patients, aged 56 and 52 years old, who presented to Abidjan Heart Institute for ACS. Coronary angiography showed spontaneous dissection of the right coronary artery in the first case, and dissection of the distal left anterior descending artery in the second. A conservative approach was preferred. Both patients received antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors and statins, with a favorable in-hospital course. These cases highlight SCAD as a possible cause of ACS. Implementation of interventional cardiology in Sub-Saharan Africa will help identify this uncommon cause of ACS.
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Affiliation(s)
- H Yao
- Institut de cardiologie d'Abidjan, 01 BP V 206, Abidjan, Cote d'Ivoire.
| | - A Ekou
- Institut de cardiologie d'Abidjan, 01 BP V 206, Abidjan, Cote d'Ivoire
| | - J J N'Djessan
- Institut de cardiologie d'Abidjan, 01 BP V 206, Abidjan, Cote d'Ivoire
| | - A Zoumenou
- Institut de cardiologie d'Abidjan, 01 BP V 206, Abidjan, Cote d'Ivoire
| | - I Angoran
- Institut de cardiologie d'Abidjan, 01 BP V 206, Abidjan, Cote d'Ivoire
| | - R N'Guetta
- Institut de cardiologie d'Abidjan, 01 BP V 206, Abidjan, Cote d'Ivoire
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N'Guetta R, Yao H, Brou I, Ekou A, Do P, Angoran I, Kouamé BA, Konin C, Anzouan-Kacou JB, Kramoh KE, Adoh AM. [Prevalence and characteristics of metabolic syndrome among hypertensive patients in Abidjan]. Ann Cardiol Angeiol (Paris) 2016; 65:131-5. [PMID: 27184513 DOI: 10.1016/j.ancard.2016.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 10/21/2022]
Abstract
AIM Assess prevalence of metabolic syndrome (MetS) in black Africans hypertensive patients. POPULATION Prospective survey from 3rd November 2014 to 12th June 2015, at Abidjan Heart Institute. Study was carried out among patients aged 18 years old, admitted to external consultation. Oral consent was obtained. MetS was established based on the definitions of the NCEP-ATP III 2005 and the International Diabetes Federation (IDF). RESULTS Over 1246 hypertensive patients, 404 were included in our study. The prevalence of MetS was 48.8% according to the criteria of the NCEP-ATP III 2005 and 51% according to the IDF. We noticed a female predominance (69% against 31%, P<0.001). Central obesity (49.5%) and low HDL-cholesterol (42.1%) were the factors defining the SM most predominant in our series. Low blood pressure control was higher in the presence of MetS (43.6%). The average number of antihypertensive prescribed drugs were significantly higher (2.2±0.8 against 2±0.8, P<0.001). MetS was significantly associated with obesity (BMI≥30kg/m(2) : 40.6% against 14%, P<0.001). Cardiovascular complications were observed in 54.8% of hypertensive patients in the presence of MetS. CONCLUSION MetS is a reality in sub-Saharan Africa. Adequate preventive measures are needed to limit its progression.
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Affiliation(s)
- R N'Guetta
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
| | - H Yao
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - I Brou
- Laboratoire de biostatistique et d'informatique médicale, centre hospitalier universitaire de Cocody, Abidjan, Côte d'Ivoire
| | - A Ekou
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - P Do
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - I Angoran
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - B A Kouamé
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - C Konin
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | | | - K E Kramoh
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - A M Adoh
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
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9
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N'Guetta R, Yao H, Ekou A, Boka B, Konin C, Coulibaly I, Anzouan-Kacou JB, Seka R, Adoh M. [Coronary artery aneurysms probably due to Kawasaki's disease]. J Mal Vasc 2016; 41:224-227. [PMID: 27090101 DOI: 10.1016/j.jmv.2016.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
We report the case of a young adult admitted to the Abidjan Heart Institute for coronary angiography to explore unstable angina. Coronary angiography showed multiple aneurysms which suggested sequelae of misdiagnosed Kawasaki disease.
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Affiliation(s)
- R N'Guetta
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire.
| | - H Yao
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire
| | - A Ekou
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire
| | - B Boka
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire
| | - C Konin
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire
| | - I Coulibaly
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire
| | - J B Anzouan-Kacou
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire
| | - R Seka
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire
| | - M Adoh
- Institut de cardiologie d'Abidjan, 01 BP V206, Abidjan, Côte d'Ivoire
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10
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N'Guetta R, Yao H, Ekou A, N'Cho-Mottoh MP, Angoran I, Tano M, Konin C, Coulibaly I, Anzouan-Kacou JB, Seka R, Adoh AM. [Prevalence and characteristics of acute coronary syndromes in a sub-Saharan Africa population]. Ann Cardiol Angeiol (Paris) 2016; 65:59-63. [PMID: 26988750 DOI: 10.1016/j.ancard.2016.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
AIM To assess prevalence, characteristics and management of acute coronary syndromes in sub-Saharan Africa population. PATIENTS AND METHODS Prospective survey from January, 2010 to December, 2013, carried out among patients aged 18 years old, admitted to intensive care unit of Abidjan Heart Institute for acute coronary syndrome (ACS). RESULTS Four hundred and twenty-five (425) patients were enrolled in this study. Prevalence of ACS was 13.5%. Mean age was 55.4±11 years. Clinical presentation was predominantly ST-segment elevation myocardial infarction (STEMI) in 71.5% of subjects, non-ST-segment elevation acute coronary syndrome (NSTE-ACS) accounted for 28.5%. Two hundred and eighty patients (65.9%) were transferred by unsafe transportation. Among the 89 patients admitted within 12hours of the onset of symptoms, primary percutaneous coronary intervention was performed in 20 patients (22.5%), or 6.6% of STEMI as a whole. Twenty-five patients (8.2%) received fibrinolytic therapy with alteplase. In-hospital death rate was 10%. CONCLUSION The prevalence of acute coronary syndromes is increasing in sub-Saharan Africa. Excessive delays of admission and limited technical facilities are the major difficulties of their management in our regions.
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Affiliation(s)
- R N'Guetta
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
| | - H Yao
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - A Ekou
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | | | - I Angoran
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - M Tano
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - C Konin
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - I Coulibaly
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | | | - R Seka
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - A M Adoh
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
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11
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Anzouan-Kacou JB, N'Guetta R, Seka R, Kakou GM, N'Zi KP, Abouo-N'Dori R. [Left atrial mass observed in a patient in Abidjan, Ivory Coast]. Med Trop (Mars) 2008; 68:179-181. [PMID: 18630053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The purpose of this report is to present a case involving a tumor-like mass in the left atrium of a 27-year-old woman in Abidjan, Ivory Coast. The mass was discovered by echocardiography carried out after cardiomegaly was detected by roentgenography performed in the context of debilitated general condition, fever and positive serology for HIV1. The patient responded favorably to anti-tuberculosis treatment with complete regression of the mass and improvement of general condition. Based on this outcome, the most likely diagnosis was cardiac tuberculoma, a rare complication of tuberculosis.
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Affiliation(s)
- J B Anzouan-Kacou
- Service de Médecine et des Urgences, Institut de Cardiologie d'Abidjan, BP V 206, Abidjan, Côte d'Ivoire.
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12
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Konin C, Adoh M, Coulibaly I, Kramoh E, Safou M, N'Guetta R, N'Djessan JJ, Koffi J. [Black Africans' compliance to antihypertensive treatment]. Arch Mal Coeur Vaiss 2007; 100:630-634. [PMID: 17928765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
UNLABELLED Hypertension is increasing in sub-Saharan Africa. It is difficult to follow a correct treatment in this environment. PURPOSE Assessing the compliance of the drug therapy and identifying the characteristics of poor observant patients. METHODS A study was carried out over one month at the outpatient department of the Abidjan Heart Institute among 200 sub-Saharan African hypertensives. Their compliance was estimated with the Compliance Evaluation Test of Girerd. RESULTS The average age of the patients was 59 years and 59.5% of them were women. Most patients (60%) had a monthly pay lower than 100,000 CFA (Euros 152). Sixty two percent had no medical insurance. So 175 patients (87.5%) had difficulties to follow their treatment. Among them 55% had a very bad compliance and 32.5% had minor difficulties. Only 12.5% of them had a right compliance. A bad compliance was frequent between 30 and 70 years, in women (60.5%), in unemployed patients (93.7%), in married women (68.7%) and in executives (50%). Other factors of a poor compliance was a monthly income lower than 100,000 FCFA (64%), a number of daily tablets higher than three (77.3%), a number of daily administration >or= $ 3 (95.7%) and the high cost of drugs. A bad compliance is more frequent when herbal treatment is associated with medical drugs or used separately. CONCLUSION The compliance of the antihypertensive treatment was poor. The causes are numerous, but they are very often related with the growing poverty in the black society.
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Affiliation(s)
- C Konin
- Institut de cardiologie d'Abidjan (Cote d'Ivoire)
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