Epidemiological Aspects of Acute Coronary Syndromes in Saint-Louis, Senegal

Introduction: The prevalence of cardiovascular diseases has been rapidly increasing in developing countries, leading to an increasing incidence of acute coronary syndrome which is becoming a major health concern. Few studies have been conducted in hospital settings, which has led us to conduct this cross-sectional, descriptive study in Saint Louis in the north of Senegal, (250 km away from the capital) whose objective is to describe the epidemiological aspects of acute coronary syndrome (ACS) in hospital settings. Methodology: This is a cross-sectional descriptive and retrospective study lasting two years from January 1, 2018 to 31 December 2019 which included all patients hospitalized in the cardiology department of the regional hospital of salary for an ACS. Results: Out of 475 patients admitted to the department of cardiology, 47 presented with acute coronary syndrome which is a prevalence of 9.89%. The mean age was 63+/-13.14 years. There was a male predominance with a sex ratio of 1.5. The meantime between the beginnings of symptoms to hospitalization was 50 hours. The most frequent clinical presentation was acute coronary syndrome with ST segment elevation (STEMI: ST-segment Elevation Myocardial Infarction) in 39 patients. Hypertension was the most common cardiovascular risk factor in 23 patients and chest pain was the most common symptoms 72.3%. In STEMI patients, the ECG abnormalities were mainly in the anterior region and in NSTEMI (Non-ST-segment Elevation Myocardial Infarction) patients the ECG abnormalities were mainly in the inferior region. On echocardiography, 64% of patients had an altered left ventricular ejection function in STEMI patients whereas in NSTEMI patients, the left ventricular ejection function was preserved in 71% of cases. STEMI patients received within the first 12 hours represented 66% of our population of which 84% benefited from thrombolysis with streptokinase with a success rate of 52%. The mean time to thrombolysis was six hours. Six patients or 12.76% were sent for coronarography. The most common complication was cardiovascular collapse (11%), 15% of patients died. Conclusion: The prevalence of acute coronary syndrome is increasing in West Africa with a predominance of ST segment elevation acute coronary syndromes. The main issues encountered were long leading times between onset of symptoms and hospital admission along with limited availability of medical facilities.