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Abstract Background Few studies have addressed the pattern of atrial fibrillation (AF) in rural Africa. The purpose of the study was to assess the epidemiology and long-term prognosis of AF in rural African patients in the Regional Hospital Center (RHC) of Tenkodogo, Burkina Faso. Results Overall, 107 of 1805 cardiac cases presented with AF (prevalence of 5.9%). Six patients were excluded. Mean age was 66.56 ± 14.92 years, and 53.47% were female. Hypertension was the most prevalent cardiovascular risk factor (59.41%). Congestive heart failure (HF) was reported in 85.15% of the study patients at presentation. Most of the study population presented with severe underlying heart disease (93.1%), and hypertensive heart disease was the most prevalent with 45.54% of the cases. The mean CHA2DS2VASc score in patients with non-valvular heart disease (n = 91) was 3.33 ± 1.25 (extremes 1–6) while the risk of bleeding was low (HAS-BLED score ≤ 1) in 82 patients (81.2%). Oral anticoagulation was prescribed in few cases (5.26%). During a follow-up period of 74.43 ± 23.94 weeks, acute HF and stroke occurred in respectively 43 and 6 patients. Forty-one patients (40.59%) died. The overall survival rate was 69% at 6-month and 59.4% at 1-year follow-up. Patients with idiopathic dilated cardiomyopathy were at higher risk of death than other patients (log-rank test = 11.88, p

INTRODUCTION: Heart failure (HF) is a strong contributor to non-communicable diseases burden in sub-Saharan Africa (SSA). Few studies have addressed the pattern of HF in Burkina Faso. METHODS: we conducted a prospective cohort study in patients with acute HF in the Regional Hospital Center of Tenkodogo, eastern region of Burkina Faso. Patients were consecutively enrolled from 1st January 2015 to 31st December 2016 and followed up until June 2017. Primary outcome of interest was mortality. RESULTS: overall 318 of 1805 cardiac cases presented with acute HF (17.62 %). Of the 298 patients included in the analysis process, 239 had de novo HF and 150 were male. The mean age was 58.56 ± 18.54 years. Eighty-eight patients presented with atrial fibrillation. The mean left ventricular ejection fraction (LVEF) was 38.20 ± 12.85 % with reduced ejection fraction (LVEF 40%) accounting for 59.73% of the cases. Most of the study patients lived in rural areas. Hypertensive heart disease (50.34%) and idiopathic dilated cardiomyopathy (19.80%) were the leading causes of HF. Most patients received renin-angiotensin system blockers contrasting with a lower prescription rate of beta-blockers (99% versus 18.79% respectively). The incidence of all-cause mortality was 31 percent patients-years. CONCLUSION: heart failure is frequent in SSA, affecting patients at younger age. Predominantly of non-ischemic cause, commonly hypertensive, the disease is associated with high mortality.

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Data on hypertensive crises (HC) are limited in sub-Saharan Africa (SSA). We aimed to characterize the pattern and short-term mortality of hypertensive emergencies (HE) and urgencies (HU). This was a prospective cohort study. Consecutive patients with acute and severely elevated blood pressure (systolic > 180 mmHg and/or diastolic >120 mmHg) with or without acute target-organs damage attending the emergency department (ED) of the Teaching Hospital of Yalgado Ouedraogo, Ouagadougou, Burkina Faso were included with a one-month follow-up. One hundred and sixty-six of 1254 patients presenting to the ED (January to march 2016) had HC (13.2%) and 113 of them (68.1%) had HE. The mean age was 50.9 ± 15.9 years and males were 63.3% (n = 105). Younger age (< 45 years) accounted for 55% of the cases. History of known HTN was reported in 101 patients (60.8%). Among patients with HE, 62.8% had brain-related events, 30.1% had cardiac involvement and 31% had acute renal impairment. The overall survival rate was 89% within the first 72 hours and 81% at fourteen days follow-up. At one-month follow-up, 36 patients died with a survival rate of 77.8%. Factors independently associated with death were history of known hypertension, acute brain-related damage and renal dysfunction and not being transferred to a specialized department. HC are not rare in SSA and are associated with higher morbidity and mortality in HE. Further studies are needed to determine factors that promote HC in African patients in order to better address the prevention and management strategies of such hypertensive entity. [ABSTRACT FROM AUTHOR]

Résumé Objectifs L'objectif de cette étude a été d'étudier le profil évolutif des syndromes coronaires aigus (SCA) en fonction des scores de risque GRACE, TIMI et SRI chez les patients hospitalisés dans le service de cardiologie du centre hospitalier universitaire Yalgado Ouédraogo (CHU YO). Patients et méthodes Il s'agit d'une étude prospective monocentrique de 111 patients consécutifs admis pour SCA (âge moyen de 57,61 ans, 77,5 % de sexe masculin) entre le 1er janvier 2010 et le 31 mai 2015. Résultats La prévalence des SCA était de 4,2 %. Les patients étaient admis pour SCA ST+ et SCA non ST+ dans respectivement 88,3 % et 11,7 %. Dix-neuf patients (17,1 %) étaient admis avant la 12e heure. La mortalité hospitalière était de 8,1 % et passait à 16,2 % en un mois. Après stratification du risque, la survie à un mois des patients à risque élevé, était plus courte que celle des patients à risque faible quel que soit le score GRACE (log-rank = 9,93 ; p = 0,007), TIMI (log-rank = 14,91 ; p = 0,001) et SRI (log-rank = 10,01 ; p = 0,006). Les scores GRACE (HR = 1,01 ; p = 0,002), TIMI (HR = 1,33 ; p = 0,01) et SRI (HR = 1,02 ; p = 0,01) étaient des facteurs pronostiques majeurs de survie globale. Conclusion Les SCA demeurent une pathologie grave avec une morbi-mortalité élevée dans les jours qui suivent l'accident initial. Ces scores de risque sont des outils applicables au Burkina Faso comme en atteste la statistique C (GRACE = 0,75, TIMI = 0,78 et SRI = 0,74). Abstract Objectives The aims of this study was to assess evolution profile of acute coronary syndrome (ACS) based on risk level by GRACE, TIMI and SRI scores in the cardiology department, Yalgado Ouedraogo university hospital. Patients and methods This was a prospective study of 111 consecutive patients admitted for ACS (mean age 57.61 years, 77.5% male) between January 1st and 2010 to May 31st 2015 in the department of cardiology. For each patient, risk scores were calculated and they were divided into risk group. Global survival at one month was described by Kaplan Meier method and prognostic factors were analyzed by multivariable Cox regression. Results The prevalence of ACS was 4.2%. Patients were admitted for ST-elevation ACS and non-ST-elevation ACS in 88.3% and 11.7%, respectively. Nineteen patients (17.1%) were admitted before the 12th hour. Hospital mortality was 8.1% and increased to 16.2% in one month. After risk stratification, one-month survival of patients with high risk, was shorter than patients at low-risk regardless of the score GRACE (log-rank = 9.93, P = 0.007), TIMI (log-rank = 14.91, P = 0.001) and SRI (log-rank = 10.01, P = 0.006). GRACE score (HR = 1.01; P = 0.002), TIMI (HR = 1.33; P = 0.01) and SRI (HR = 1.02; P = 0.01) were major prognostic factors for overall survival. Conclusion ACS remains a serious disease with high morbidity and mortality in the days following the initial accident. These risk scores are applicable tools in Burkina Faso as evidenced statistic C (GRACE = 0.75, TIMI = 0.78 and SRI = 0.74). [ABSTRACT FROM AUTHOR]