Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

Acute Coronary Syndrome of Young Subjects at the Luxembourg Mother-Child University Hospital in Bamako

Introduction: Acute coronary syndrome is often the first event of coronary disease of young subjects. Objective: To study sociodemographic, clinical, paraclinical, therapeutic and evolutionary aspects of acute coronary syndrome of young subjects. Patients and Methods: Descriptive cross-sectional study with prospective recruitment from October 01, 2020 to March 31, 2022. Were included all patients admitted for acute coronary syndrome whose age was less or equal to 45 years and who had undergone coronary angiography at the Mother-Child University Hospital on Luxembourg from Bamako. Results: During the study period, we collected 60 patient files out of 198. These 60 patient files met our inclusion criteria. Hospital frequency was 30.30%. Average age of patients was 40.43 ± 3.9 years. Sex ratio M/F was 5.3. Main cardiovascular risk factor was smoking tobacco (23.42%), followed by dyslipidemia (13.92%). Functional signs were dominated by angina 62% followed by dyspnea 25.3%. Persistent ST-segment elevation on electrocardiogram was present in 76.4%. Left ventricular systolic dysfunction was present in 26.5%. Time to first medical contact was more than 12 hours in 62.7% of cases. Radial approach was adopted in 94% of cases. Coronary angiography was pathological in 85% (n = 51) of cases. Lesions were single-vessel disease in 47.1% and culprit artery was anterior interventricular in 51% of cases. Dual anti-platelet aggregation was aspirin and ticagrelor in 91.8% of cases. Angioplasty was performed in all patients who had significant abnormalities at coronary angiography. In-hospital mortality was 3.9%. Conclusion: Acute coronary syndromes exist in young Africans with a male predominance. Main cardiovascular risk factor is smoking tobacco. Coronary lesions are single vessel disease in the majority of case. Most of patients meet medical team after 12 hours. Time to first medical contact is a main challenge in our country.

Hypertension (Htn) among Young People of 18 to 35 Years Old in Cardiology Department of Gabriel Toure University Teaching Hospital

Few studies have been conducted on hypertension among youth in Mali?hence the interest of our study aimed to clarify certain aspects what are not taken account yet in previous studies.?Objective: Determine the clinical and para-clinical characteristics of hypertension among 18 to 35 years old young people.?Methods:?This cross-sectional and retrospective study of 24 months from January 1st, 2009 to December 31st, 2010?in the cardiology department of the Gabriel Touré UTH.?Results:?We identified 132 cases during the study period out of 2146 cases of hypertension with a prevalence of 6.1%. The female gender represented 81.8%, with a sex ratio of 45.59, 1% of patients had an unknown family history of hypertension. The age group of 31 to 35 years accounted for 43.9%. The circumstances of discovery were dominated by exertional dyspnea (37.9%). Body mass index was normal in 45.5% of patients. The higher BMI was more common in female patients with 39.39% (p?= 0.045). In the sample,53% of patients had a systolic blood pressure between 140?and 159 mmHg and 38.6% had diastolic blood pressure ≥ 110 mmHg with no significant difference (p?> 0.5). The high creatinine level was found in 18.18% of our patients. The ECG?found?84.6%?of left ventricular hypertrophy among cavitary hypertrophies. The echocardiography has found cavitary?dilatation in 40.04% of cases;it concerned the left ventricle in 25.71%. Also 18.57% of our patients had impaired left ventricular systolic function. Among the complications found in our patients, kidney failure led with 56%.?Conclusion:?Hypertension is not a rare event among young population even with a normal body mass index. It is often discovered during complications that can be dreadful.