[Coronary lesions in black African patients with acute coronary syndromes]
Hermann Yao1, Arnaud Ekou1, Thierry Joseph Niamkey2
1Service des Soins Intensifs Médicaux, Institut de Cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
Insights
This study reveals distinct coronary lesion patterns in acute coronary syndromes (ACS) patients in Abidjan. ST-elevation myocardial infarction (STEMI) showed more one-vessel disease, while non-ST-elevation ACS (NSTE-ACS) had diffuse disease but more normal arteries.
Area of Science:
- Cardiology
- Interventional Cardiology
- Public Health
Background:
- Acute coronary syndromes (ACS) are rising in sub-Saharan Africa.
- Coronary angiography data from the region are scarce.
- This study addresses the need for local data on ACS coronary lesions in Abidjan.
Purpose of the Study:
- To investigate and compare coronary lesions in patients with ACS in Abidjan.
- To differentiate lesion characteristics between ST-elevation ACS (STEMI) and non-ST-elevation ACS (NSTE-ACS).
Main Methods:
- Cross-sectional study conducted from January 2010 to December 2014.
- Included 256 patients with ACS undergoing coronary angiography at the Abidjan Heart Institute.
- Compared coronary lesions in STEMI versus NSTE-ACS patient groups.
Main Results:
- Higher abnormal coronary angiography rates in STEMI (95.4%) vs. NSTE-ACS (64.2%).
- STEMI patients predominantly had one-vessel disease (45.3%), while NSTE-ACS patients showed two or three-vessel disease (68.0%).
- Complex type C lesions were more frequent in STEMI (17.8%); NSTE-ACS had more Type B1 lesions (62.8%).
Conclusions:
- STEMI patients exhibited predominantly one-vessel coronary lesions.
- NSTE-ACS patients presented with more diffuse disease but a higher rate of normal coronary arteries.
- Management primarily involved coronary angioplasty for the majority of patients.
Introduction:
acute coronary syndromes (ACSs) have been increasing in sub-Saharan Africa. Coronary angiography data have been rarely reported. This study aims to investigate coronary lesions observed in patients with acute coronary syndromes (ACS) in Abidjan.
Methods:
we conducted a cross-sectional study from 1st January 2010 to 31st December 2014. All patients with ACS admitted to the Abidjan Heart Institute and undergoing coronary angiography during the study period were included. Two hundred and fifty-six patients were selected. We investigated and compared coronary lesions in patients with ACS associated with persistent ST-segment elevation (ACS ST+) and in those with ACS without ST-segment elevation (ACS ST-).
Results:
the average age of patients was 53.2 ± 10.8 years; there was a male predominance, with a sex ratio of 6.1. Abnormal coronary angiography rate was significantly higher in the STEMI group (95.4% and 64.2% respectively, p < 0.001). Three hundred and four coronary lesions were found in the STEMI group against 43 in the NSTE-ACS group. Stenotic lesions were predominantly one-vessel disease (45.3%) in the STEMI group and two or three-vessel disease in the NSTE-ACS group (68.0%). Type B1 lesions were more common in the NSTE-ACS group (62.8% versus 36.5%, p = 0.002). The most complex type C lesions were more commonly found in the STEMI group (17.8%), with no significant difference. The majority of patients had SYNTAX score less than 22, whatever the type of ACS (87.4% in the STEMI group and 90.1% in the NSTE-ACS group).
Conclusion:
coronary lesions in the patients group with STEMI were predominantly one-vessel disease and they were more diffuse in the NSTE-ACS group, but with a higher proportion of angiographically normal coronary arteries. The management of patients with these lesions is based in the majority of cases on coronary angioplasty.
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