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Aim: Describe the epidemiology, diagnosis and risk factors of hypertension in pregnant women in Lome. Methods: It was a prospective, descriptive and comparative study during 12 months (October 1st, 2011 to September 31st, 2012) on 200 cases of hypertension among 1620 pregnant women, in the department of gynecology and obstetrics at the Tokoin teaching hospital of Lome. Results: We had 200 cases of hypertension on 1620 pregnant women. The prevalence of hypertension in pregnant women in Lome was 12.3%. The average age of pregnant women was 30 ± 7 years, with extremes of 15 and 44 years. Hypertension was more common (50%) in ages of 30-39 years. The society the most represented were housewives (33.33%), civil servants (16.67%) and traders (16.66%). Hypertension was found incidentally or during a complication especially during the third trimester of pregnancy. Preeclampsia (44%) and pregnancy-induced hypertension (33%) were the most represented. The main risk factors where primiparity (especially older primipars >30 ans), nulliparity, familial history of hypertension, low economic level, history of pregnancy-induced hypertension, age >30 years, twinning, obesity and stress. Conclusion: Hypertension in pregnancy is frequent in Lome. A regular follow-up before and after delivery is important according to fetal and maternal complications, and the risk of heart and kidney disease at mild and long outcome. [ABSTRACT FROM AUTHOR]

A lower mortality rate from coronary artery disease (CAD) and a more favourable lipid profile have been reported in Afro-Caribbeans compared with people of European ancestry. The aim of this study was to determine whether common lipid variants identified in other populations are associated with lipid levels and CAD in Afro-Caribbeans. We studied 705 Afro-Caribbeans (192 with CAD) who were genotyped for 13 lipid-associated variants. We calculated three polygenic risk scores (PRSs) for elevated LDL (LDL-PRS), decreased HDL (HDL-PRS), and elevated triglycerides (TG-PRS). LDL-PRS, HDL-PRS, and TG-PRS were associated with LDL, HDL, and TG levels, respectively. The LDL-PRS was positively associated with LDL > 2.6 mmol/L and with LDL > 3.0 mmol/L with ORs (odds ratios) of 1.33 (95% confidence interval (CI) = 1.14-1.56) and 1.40 (CI = 1.21-1.62), respectively. The HDL-PRS was associated with a low HDL category (HDL < 1.03 mmol/L) with an OR of 1.3 (CI = 1.04-1.63) and inversely associated with a high HDL category (HDL > 1.55 mmol/L) with an OR of 0.79 (CI = 0.65-0.96). The LDL-PRS was positively associated with CAD after adjustment for age, gender, hypertension, diabetes, and smoking with an OR of 1.27 (CI = 1.06-1.51) but not the HDL-PRS nor the TG-PRS. Results of the present study indicate that common lipid variants are associated with lipid levels and prevalent CAD in Afro-Caribbeans.

Background: Our study aimed to describe the clinical, paraclinical, therapeutic and outcomes of patients with venous thromboembolic event (VTE) associated with cancer in the context of limited resources., Materials and Methods: This was a descriptive cross-sectional study over a period of six years from March 1, 2016 to March 31, 2022, in the cardiology department and the oncology unit of the Sylvanus Olympio Teaching Hospital of Lome. Our study examined medical records of patients who were at least 18 years old and had venous thromboembolic disease and cancer that was histologically confirmed. This study did not include records that were incomplete or records from patients with coronavirus disease., Results: Our study included 87 patients with average age of 56.36±15.26 years. The discovery of VTE occurred incidentally in 28.74%. Venous thrombosis was isolated in 68.96% and proximal in 95%. Pulmonary embolism was bilateral in 77.77%. Gynaecological and urological cancers were found in 33.33% and 32.19% respectively. Adenocarcinoma was the histological type of cancer found in 47.13%. Cancers were at a very advanced stage in 74.71%. Treatment with antivitamin K was prescribed in 12.65%. In our study, there were 58 patients who passed away with a mortality rate of 66.66%. The cause of death was a complication of VTE in 22.42% and related to the course of cancer in 63.79% of cases., Conclusion: VTE during cancer is particular with a fatal evolution due to the severity of VTE and the very advanced stage of cancer., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background: Our aim was to describe the prevalence of metabolic syndrome (MetS) and its components among Afro-Caribbean adults without diabetes and cardiovascular complications. Methods: Participants were recruited from a Health Center in Guadeloupe, French West Indies. MetS was defined according to the NCEP ATP III. Prevalence of MetS and MetS components were compared across age groups and sex. The odds ratios (ORs) and 95% confidence intervals were obtained using logistic regression. Results: There were 1011 participants (68.8% women, mean age 47.8 ± 11.8 years). Prevalence of MetS was 17.9% (21.1% women, 10.8% men) and increased by age in women. High blood pressure had the highest prevalence among men and among women ≥60 years. Prevalence of abdominal obesity (AbO) was higher in women than in men. High triglyceride levels were uncommon at all ages and, men and women <40 years, compared with the other groups had higher prevalence of low high-density lipoprotein cholesterol (HDL-C) levels. With multiple logistic regression, compared with adults <40 years, those ≥60 years had the highest OR for prevalent hypertension 7.8 (4.8-12.8); P  < 0.001, AbO 2.1 (1.3-3.3); P  = 0.002 and high fasting blood glucose levels 5.5 (3.1-9.8); P  < 0.001. They also had lower odds for having low HDL-C than the younger ones (G1: age <40 years). Among persons ≥60 years, OR for MetS was 1.9 (1.1-3.6); P  = 0.013 compared with the referent group. Compared with men, women had higher odds of MetS 2.2 (1.5-3.3); P  < 0.001. Conclusion: Women were more likely to have MetS than men and persons ≥60 years were significantly more likely to have MetS than persons <40 years. Preventive measures are required to reduce the prevalence of MetS.

Background Data in the literature on acute coronary syndrome in sub-Saharan Africa are scarce. Methods and Results We conducted a systematic review of the MEDLINE (PubMed) database of observational studies of acute coronary syndrome in sub-Saharan Africa from January 1, 2010 to June 30, 2020. Acute coronary syndrome was defined according to current definitions. Abstracts and then the full texts of the selected articles were independently screened by 2 blinded investigators. This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. We identified 784 articles with our research strategy, and 27 were taken into account for the final analysis. Ten studies report a prevalence of acute coronary syndrome among patients admitted for cardiovascular disease ranging from 0.21% to 22.3%. Patients were younger, with a minimum age of 52 years in South Africa and Djibouti. There was a significant male predominance. Hypertension was the main risk factor (50%-55% of cases). Time to admission tended to be long, with the longest times in Tanzania (6.6 days) and Burkina Faso (4.3 days). Very few patients were admitted by medicalized transport, particularly in Côte d'Ivoire (only 34% including 8% by emergency medical service). The clinical presentation is dominated by ST-elevation sudden cardiac arrest. Percutaneous coronary intervention is not widely available but was performed in South Africa, Kenya, Côte d'Ivoire, Sudan, and Mauritania. Fibrinolysis was the most accessible means of revascularization, with streptokinase as the molecule of choice. Hospital mortality was highly variable between 1.2% and 24.5% depending on the study populations and the revascularization procedures performed. Mortality at follow-up varied from 7.8% to 43.3%. Some studies identified factors predictive of mortality. Conclusions The significant disparities in our results underscore the need for a multicenter registry for acute coronary syndrome in sub-Saharan Africa in order to develop consensus-based strategies, propose and evaluate tailored interventions, and identify prognostic factors.

Objectives: To evaluate the prevalence and determinants of increased carotid intima-media thickness (IMT) in a population of black hypertensive patients and it influence of on the assessment of their overall cardiovascular risk., Patients and Methods: This was a 16-month, cross-sectional study conducted in the outpatient unit of the cardiology department of the Campus teaching hospital of Lome, and included 1203 hypertensive patients, both sexes, aged 35 years and more. Each patient benefited from a carotid IMT measure. Carotid IMT was increased if it was>0.9mm and the plaque was defined as a carotid IMT>1.2mm., Results: The mean age of our patients was 53.3±10.4 years with a sex ratio of 1.6 in favor of women. The duration of hypertension was less than 5 years in 56.7% and hypertension was grade 1 in 47.7% of cases. The mean carotid IMT was 0.89mm±0.20. The prevalence of the increased carotid IMT was 45.8% and that of an atheroma plaque was 15.8%. Carotid IMT was correlated with age (P˂0.0001), duration of arterial hypertension (P=0.01), history of stroke (P˂0.0001), and presence of left ventricular hypertrophy to cardiac ultrasound (P=0.01). The overall cardiovascular risk was modified after taking into account the carotid IMT. An increase in cardiovascular risk was observed in 30.5% of hypertensive patients., Conclusion: Increased carotid intima-media thickness is frequent in Togolese hypertension. The determining factors are age, duration of arterial hypertension, left ventricular hypertrophy and stroke. The systematic measurement of the carotid intima-media thickness would better evaluate the overall cardiovascular risk for our patients., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Introduction: High-risk pulmonary embolism (PE) accounts for 5% of total acute PE and is a life-threatening emergency requiring immediate therapeutic management by fibrinolysis. The objective of this work is to describe the experience of thrombolysis in high-risk PE in a cardiology department in Togo., Patients and Methods: This is an analytical and descriptive study carried out in the cardiology department of the Campus teaching hospital of Lomé over a period of 5 years (August 2012 to July 2017) concerning patients hospitalized for high-risk mortality PE and having undergone streptokinase thrombolysis., Results: Twenty-eight of the 102 PE were at high risk of mortality (27.5%). They were 9 men and 19 women with an average age of 61.9±14.1 years. The mean systolic blood pressure was 65mmHg and 50% of the patients were placed on dobutamine. Thrombolysis was performed in 22 of the 28 patients (78.6%). Eighteen patients had a short protocol and 4 a long protocol. The mortality rate was 32.1% or 13.6% in the thrombolysis PE versus 100% in the non-thrombolysis PE (P=0.01). Causes of death in thrombolysis were persistent shock (2 cases) at the end of thrombolysis and sudden death occurred 1 month after hospitalization. The average hospital stay was 18.8 days., Conclusion: The high-risk PE remains today a pathology burdened with heavy mortality. Thrombolysis remains the first treatment to reduce this mortality., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Introduction: The aim of this work was to describe the epidemiological, clinical, and therapeutic characteristics of acute coronary syndromes (ACS) in the cardiology department of Lome Campus University Hospital in Togo., Methodology: We conducted a prospective study that consistently included patients hospitalized from 2014 to 2017 for ACS, based on clinical, electrocardiographic, and laboratory findings., Results: Of 1914 patients admitted to the department during the study period, 67 were admitted for ACS, for a 3.5% prevalence. The (M/F) sex ratio was 1.91. Patients' mean age was 60 ± 12 years. The clinical presentation was an ST elevation myocardial infarction (STEMI) in 71.6% of cases, and non-STEMI in 28.4% of cases, including 18.1% non-Q-wave infarction and 10.3% unstable angina. The mean time to admission after the onset of symptoms was 81.9 ± 124.6 hours. Patients were transported to the hospital by a private vehicle in 82.1% of cases. Thrombolysis was performed for 14.6% of patients (7/48 patients with ACS STEMI), with a success rate of 85.7% (n=6). In-hospital mortality was 10.5% (7/67). This mortality was significantly associated with the interval from onset of symptoms to admission and with the Killip stage., Conclusion: Acute coronary syndromes are increasingly common in Togo. They are characterized by a relatively young age and a long delay until admission. Improving the management of these conditions in our countries requires effective primary prevention.

Introduction: This study provides an analysis of the evolutionary, clinical and epidemiological aspects of pulmonary embolism at the University Hospital Campus of Lome., Methods: We conducted a retrospective, analytic and descriptive study over a period of 39 months (November 1 , 2011- January 31, 2015). All the medical records of patients hospitalized for PE in the Department of Cardiology at the University Hospital Campus were analyzed., Results: The prevalence of PE was 3.1%. Female/male sex ratio was 2.2. The average age was 52.7 ± 14.4 years. Risk factors for venous thromboembolic disease VTD were dominated by: obesity (54.9%), bedrest (25.5%) and long journey (17.6%). The main symptoms were: dyspnoea (98.0%), chest pain (78.4%) and cough (60.8%). Wells' score was high in 29.4% of cases. ECG showed: tachycardia (78.4%), right ventricular hypertrophy (RVH)(49.0%), S1Q3T3 aspect (47.1%) and right block (39.2%). Transthoracic Doppler echocardiogram showed right cavitary dilation and right intraventricular thrombus in 5.6% of cases. Thoracic angioscanner was normal in 9.8% of cases and showed embolus in 82.4% of cases. Treatment was based on Low Molecular Weight Heparin (LMWH) at therapeutic doses with antivitamin K (AVK) relay. Thrombolysis was performed in 8 patients. Evolution was favorable in 86.3% of cases. Case-fatality rate was 13.7%., Conclusion: The prevalence of PE is relatively low in our area but it is probably underestimated. PE is a therapeutic problem in Togo because of the high cost of complementary examinations and thrombolysis. Prevention is therefore the only effective weapon.

Objective: to describe the course and the etiologic, prognostic, and therapeutic aspects of effusive pericarditis (EP) in Togo. MATERIAL ANDMETHODS: Prospective and longitudinal study conducted at the cardiology department of Sylvanus Olympio Teaching Hospital of Lome from February 1, 2011, to January 31, 2014, of patients hospitalized for EP, confirmed by Doppler echocardiography., Results: The study included 38 patients. The hospital incidence rate of EP was 2.0%. The mean age was 42.5 ± 14.9 years (range: 16 to 73 years) with a sex ratio of 0.7. Exertional dyspnea, poor general condition, chest pain, and fever were the main symptoms. Pericardial effusion was abundant in 24 patients (63%). The Koch bacillus was identified on direct examination in five patients (13%) and only from sputum. HIV serology was positive in 18 patients (47%). Pericardial fluid was collected from 24 patients (63%). Pathology examinations of pericardial tissue found nonspecific inflammation in 5 patients and pericardial tuberculosis in 7. The causes of EP were: tuberculous (55%), idiopathic (16%), bacterial (8%), HIV-related (5%), uremic (5%), neoplastic (5%), lupus (3%), and rheumatic (3%)., Conclusion: EFP is a frequent, serious, even deadly disease in Africa because of the HIV-AIDS pandemic. Treatment depends on the cause, most often tuberculosis.

Aims: To determine the vascular age of patients suffering from stroke and their cardiovascular risk at 10 years and to compare their vascular age to their real age., Material and Methods: It was about a descriptive and retrospective study carried up from 1st January 2012 to 31st December 2013 at the neurologic clinic of the University teaching hospital Sylvanus Olympio of Lome from patients' files with a confirmed diagnostic of stroke according to the clinical examination and the scanner data., Results: One hundred and ninety-four patients were related to our study. They were shared-out into 101 men and 93 women equal to a sex-ratio (man/woman) of 1.08. The average real age was of 57.6 ± 13.7 years. High blood pressure was the main risk factor with a prevailing rate of 86.6%, followed by the total hypercholesterolemia (54.3%), the hypocholesterolemia HDL (22.7%), diabetes (10.8%) and nicotinism addiction (4.1%). The average vascular age for all patients was of 68.23 years. The average difference between the real age and the vascular age was of 10 years. The average cardiovascular risk at 10 years in our study was of 13.2%., Conclusion: The vascular age of patients suffering from stroke at the University teaching hospital Sylvanus Olympio of Lome is 10 years higher than their real age. This condition considerably increases their risk of cardiovascular diseases. The screening and the early care about vascular risk factors appear therefore of utmost importance., (Copyright © 2015. Published by Elsevier SAS.)