Type 2 Myocardial Infarction in a Sub-Saharan Africa Population: Challenging the Current Concepts-Data From REACTIV

Area of Science:

• Cardiology
• Internal Medicine
• Public Health

Background:

• Acute coronary syndrome (ACS) registries provide insights into myocardial infarction (MI) epidemiology.
• Type 2 myocardial infarction (T2MI) requires specific assessment due to its distinct pathophysiology.
• Understanding T2MI in diverse populations is crucial for global cardiovascular health.

Purpose of the Study:

• To determine the incidence, clinical presentation, management, and outcomes of T2MI in Côte d'Ivoire.
• To compare T2MI with type 1 MI within a West African cohort.
• To identify key differences and similarities between T2MI and type 1 MI.

Main Methods:

• Cross-sectional study utilizing data from the REACTIV registry (2018-2022).
• Inclusion of hospitalized MI patients who underwent coronary angiography.
• Collection of sociodemographic, clinical, paraclinical data, and in-hospital outcomes.

Main Results:

• T2MI constituted 14.1% of 441 MI cases analyzed.
• T2MI patients showed a trend towards younger age and less severe coronary artery disease (multivessel disease, P<0.001).
• Common T2MI triggers included coronary embolism, severe hypertension, and tachyarrhythmia. In-hospital events were low for both MI types.

Conclusions:

• Significant disparities exist in T2MI characteristics and outcomes in Côte d'Ivoire compared to Western populations.
• T2MI exhibits heterogeneity, with geographical variations in causative factors and demographics.
• These findings highlight the need for context-specific approaches to T2MI management.