RESUMEN
BACKGROUND: Hypertension is a major risk factor for cardiovascular events. The cardiovascular risk assessment is performed using specific algorithms, particularly SCORE2 and SCORE2-OP developed by the European Society of Cardiology. PATIENTS AND METHODS: Prospective cohort study from February 1, 2022, to July 31, 2022, enrolling 410 hypertensive patients. Epidemiological, paraclinical, therapeutic, and follow-up data were analyzed. Cardiovascular risk stratification of patients was performed using SCORE2 and SCORE2-OP algorithms. We compared the initial and 6-month cardiovascular risks. RESULTS: The mean age of the patients was 60.88 ± 12.35 years with a female predominance (sex ratio = 0.66). In addition to hypertension, dyslipidemia (45.4%) was the most frequently associated risk factor. A high proportion of patients were classified as high (48.6%) and very high (46.3%) cardiovascular risk, with a significant difference between men and women. Reassessment of cardiovascular risk after 6 months of treatment found significant differences compared with the initial cardiovascular risk (p < 0.001). The rate of patients at low to moderate cardiovascular risk (49.5%) increased substantially, whereas the proportion of patients at very high risk decreased (6.8%). CONCLUSION: Our study conducted at Abidjan Heart Institute in a young population of patients with hypertension revealed a severe cardiovascular risk profile. Almost half of the patients are classified at very high cardiovascular risk, based on the SCORE2 and SCORE2-OP. The widespread use of these new algorithms for risk stratification should lead to more aggressive management and prevention strategies for hypertension and associated risk factors.
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Enfermedades Cardiovasculares , Hipertensión , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pueblo Africano , Algoritmos , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Côte d'Ivoire , Factores de Riesgo de Enfermedad Cardiaca , Hipertensión/complicaciones , Hipertensión/epidemiología , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Población NegraRESUMEN
INTRODUCTION: Erectile dysfunction (ED) represents an independent and/or predictive risk factor for coronary heart disease according to many studies. The aim of our study is to determine the prevalence and risk factors associated with erectile dysfunction in coronary patients confirmed by coronary angiography. MATERIAL AND METHOD: We conducted a descriptive and analytical cross-sectional study. A total of 60 patients were included with proven atheromatous coronary lesions after coronary angiography. The study period was from June 1, 2020 to February 29, 2021. After assessment of erectile status based on the short version of the International Index of Erectile Function (IIEF-5). Measures of association were adjusted odds ratios and odd ratios with their confidence intervals. Multivariate analysis was conducted using logistic regression. Only patients with erectile insufficiency underwent penile pharmocodoppler. RESULTS: The mean age was 56 ± 8.4 years with extremes of 28 and 65 years. Erectile status was classified according to the IIEF-5 score as follows: severe ED (32%), moderate (13%), mild (15%) and normal erectile function (40%). The time to onset of ED was> 2 years in 69.4% of cases before the onset of coronary artery disease with a mean time of 2.37 years ± 1.29. In 20% of the cases, the patients were already on treatment before the erectile disorder, 65% undergoing treatment after the erectile disorder and 15% had no undergoing treatment. The main factors associated with ED were: high blood pressure (OR = 7; p = 0.0007), dyslipidemia (OR = 4.86; p = 0.004), diabetes (OR = 3.8; p = 0.02), obesity (OR = 4, 45; p = 0.02) as well as beta blockers (OR = 5.3; p = 0.004), calcium channel blockers (OR = 4.5; p = 0.004) and angiotensin-converting enzyme inhibitors (OR = 4.3; p = 0.008). The vascular cause clearly dominates (95%) of which 61% arterial mechanism, 17% mixed and 17% venous mechanism. The factor associated with a decrease PSVpi was the diabetes (OR = 28; p = 0.01). In multivariate analysis, no factor was statistically associated with ED or decrease in PSVpi. CONCLUSION: Isolated ED appears as an early marker of generalized endothelial dysfunction. Hence the advantage of systematic screening, especially in subjects at risk of cardiovascular disease.
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Diabetes Mellitus , Disfunción Eréctil , Masculino , Humanos , Persona de Mediana Edad , Disfunción Eréctil/epidemiología , Disfunción Eréctil/etiología , Disfunción Eréctil/diagnóstico , Prevalencia , Estudios Transversales , Côte d'Ivoire/epidemiología , Factores de RiesgoRESUMEN
BACKGROUND: To assess the evolution of the epidemiology and management of patients hospitalized to Abidjan Heart Institute for acute coronary syndrome (ACS). METHODS: Cross-sectional study comparing two periods: from January 2002 to December 2009 (period 1) and from January 2010 to December 2016 (period 2), including all patients aged 18 years old, admitted to Intensive Care Unit of Abidjan Heart Institute for ACS. RESULTS: One thousand eleven (1011) patients were included among the 6784 patients admitted to Intensive Care Unit of Abidjan Heart Institute for a cardiovascular disease. The overall prevalence of ACS was 14.9%. The prevalence in period 2 was significantly higher than in period 1 (22.6% and 7.3% respectively, p < 0.001). Diabetes (33.5%, p < 0.001) significantly, and smoking (30.7%, p = 0.30) had the largest rises from period 1 to period 2. ST-segment Elevation Myocardial Infarction was the main clinical presentation during both periods. The median time to treatment (p = 0.46) and length of hospital stay (p <0.001) decreased during period 2. Percutaneous coronary intervention (PCI) was performed in 173 patients (22.6%) during the period 2 and 42 patients (5.5%) underwent primary PCI. The rate of fibrinolysis increased significantly between the two periods (9.5%, p <0.001). In-hospital death increased during period 2 (10.4%, p = 0.07). CONCLUSION: The burden of ACS and its related mortality have risen alarmingly past years in Côte d'Ivoire. Healthcare policies should help improve the management and outcomes of patients.
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Síndrome Coronario Agudo , Intervención Coronaria Percutánea , Síndrome Coronario Agudo/epidemiología , Síndrome Coronario Agudo/terapia , Adolescente , Côte d'Ivoire/epidemiología , Estudios Transversales , Mortalidad Hospitalaria , Humanos , Intervención Coronaria Percutánea/efectos adversos , Resultado del TratamientoRESUMEN
AIM: To investigate home blood pressure monitoring (HBPM) practice among treated hypertensive patients in a subsaharan Africa setting. PATIENTS AND METHODS: Cross-sectional observational study over a five-month period from April 30 to September 30, 2019. The survey was carried out among treated hypertensive patients aged at least 18-years-old, received in outpatient consultations department at the Abidjan Heart Institute during the study period. We assessed the rate of patients performing HBPM, and compared characteristics and rate of blood pressure control between patients according to the realization of HBPM. RESULTS: Three hundred hypertensive patients (mean age 59.2±12.0 years, sex ratio 1.4) were included. Of these, 68.3% reported to have information about HBPM. In 42.3% of cases, patients had an electronic blood pressure device at home, the majority of which were devices with arm cuffs (65.3%). The study showed that 40.3% of the patients had received education on hBPSM, most commonly provided by practitioners (71.9%). Among our population study, 36.3% performed HBPM, of whom only 13.8% according to the 3-day standardised protocol. In multivariate analysis, HBPM appeared to be an independent factor associated with better blood pressure control. CONCLUSION: HBPM is rarely used by patients with hypertension in our practice. Most of the patients do not receive education about HBPM and adequate training in order to perform it routinely.
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Monitoreo Ambulatorio de la Presión Arterial , Hipertensión , Adolescente , Anciano , Presión Sanguínea , Côte d'Ivoire , Estudios Transversales , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Persona de Mediana EdadRESUMEN
BACKGROUND: Coronary artery disease is mainly due to atherosclerosis. The aim of this study was to evaluate the frequency of peripheral arterial disease in proven coronary artery disease and to determine the associated factors in our context. MATERIAL AND METHODS: We included in a cross-sectional descriptive and analytical study 224 patients with proven coronary artery disease confirmed on coronary angiography from March 1 to October 30, 2019. It took place in the external exploration department of the Abidjan Heart Institute. An ultrasonographic exploration of the supra-aortic trunks and arteries of the lower extremity with measurement of the ankle brachial index (ABI) was carried out. RESULTS: The mean age was 57.4±10.9 years (27-81years). There was a clear male predominance with a sex-ratio of 5. The prevalence of carotid artery disease was 56.4% of patients. The main factors associated with elevated Intima Media Thickness (IMT) and the presence of carotid plaques were male sex (OR=8.8; P=0.038), smoking (OR=2.5; P=0.049) and multi-truncular involvement (OR=3.2; P=0.014). In the lower extremities, there was a prevalence of peripheral arterial disease of 48.5%. The main factors associated with the decrease of ABI were age ≥50 years (OR=2.6; P=0.043), diabetes (OR=2.8; P=0.02), dyslipidemia (OR=3.8; P=0.001) and pluri-truncular involvement (OR=4.5; P<0.0001). CONCLUSION: The presence of significant coronary artery disease in our context is associated with a high prevalence of peripheral carotid artery and lower extremity artery disease. This is all the more so as we are male, over 50 years old, pluri-truncular with many cardiovascular risk factors.
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Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad Arterial Periférica/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice Tobillo Braquial , Grosor Intima-Media Carotídeo , Estenosis Carotídea/epidemiología , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Côte d'Ivoire/epidemiología , Estudios Transversales , Femenino , Humanos , Extremidad Inferior/irrigación sanguínea , Masculino , Persona de Mediana Edad , Enfermedad Arterial Periférica/diagnóstico por imagen , Distribución por Sexo , Factores Sexuales , Fumar/efectos adversos , UltrasonografíaRESUMEN
BACKGROUND: The usefulness of the combined assessment of HbA1c and plasma glucose (PG) in acute myocardial infarction (AMI) in non-diabetic patients remains unclear. PURPOSE: In a large observational study, we aimed to identify the prognostic values of these biomarkers regarding one-year all-cause mortality in non-diabetic patients after AMI. METHODS: From the "obseRvatoire des Infarctus de Côte d'Or" (RICO) survey database, we included all consecutive non-diabetic patients with AMI (n=6617) from May 2001 to December 2016. Exclusion criteria were: admission known or unknown diabetes, in-hospital death. The primary endpoint was all-cause one-year mortality. The secondary endpoints were: MACE, infarct size, LVEF<40% and GRACE risk score. Cut-off levels (high/low) were determined by ROC curve analysis for the prediction of one-year death (HbA1c 5.9% and PG 131mg/dL) to set up 4 groups: low HbA1c/low glucose (n=3158), low HbA1c/high glucose (n=1264), high HbA1c/low glucose (n=1378) and high HbA1c/high glucose (n=817). RESULTS: Elevation of PG was associated with elevated rate of LVEF<40%, STEMI, anterior wall location, DFG<60mL/min/m2 and higher troponin Ic pic (all P<0.001); HbA1c>5.9% was associated with elevated rate of CRP>3mg/L (P<0.001); high HbA1c and high PG together were associated with higher rate of MACE (P<0.001). By multivariate logistic regression analysis, elevated admission PG remained a strong predictor of one-year all-cause [OR (95%CI): 1.64 (1.31-2.05)] mortality and cardiovascular mortality [OR (95%CI): 1.75 (1.33-2.31)], beyond GRACE score [OR (95%CI): 1.03 (1.03-1.04)], as well as elevated HbA1c [OR (95%CI): 1.43 (1.15-1.78) and OR (95%CI): 1.83 (1.39-2.41) respectively]. CONCLUSIONS: Admission PG and HbA1c had strong independent predictive value regarding one-year all-cause mortality in our non-diabetic patients with AMI. These biomarkers could be useful to identify the most-at-risk patients after AMI in order to reduce residual risk in this target population.
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Glucemia/análisis , Hemoglobina Glucada/análisis , Infarto del Miocardio/sangre , Infarto del Miocardio/mortalidad , Factores de Edad , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Causas de Muerte , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/patología , Infarto del Miocardio sin Elevación del ST/sangre , Infarto del Miocardio sin Elevación del ST/mortalidad , Pronóstico , Curva ROC , Infarto del Miocardio con Elevación del ST/sangre , Infarto del Miocardio con Elevación del ST/mortalidad , Volumen Sistólico/fisiología , Factores de Tiempo , Troponina I/sangreRESUMEN
AIM: Assess the challenges and outcomes of percutaneous coronary intervention (PCI) in the management of ACS at Abidjan Heart Institute. PATIENTS AND METHODS: Prospective survey carried out from April, 1st, 2010 to April, 29th, 2016. Whole patients aged 18-year-old, admitted at Abidjan Heart Institute for ACS, and who underwent PCI were included in the Registre prospectif des actes de cardiologie interventionnelle de l'institut de cardiologie d'Abidjan (REPACI). Indications and outcomes of PCI were analyzed. RESULTS: Seven hundred and forty-nine patients were admitted for ACS, of which 165 underwent PCI. Ratio PCI/ACS was 0.22. Mean age was 55.6±9.8 years. Male were predominant (sex-ratio=12.7). Main clinical presentation was ST-elevation myocardial infarction (STEMI) in 75.1% of cases. One-vessel disease was predominant in STEMI (52.4%), and multi-vessel disease in non-ST-segment elevation acute coronary syndromes (NSTE-ACS) (51.2%). Most of patients (86.7%) underwent PCI with stent implantation. PCI was performed successfully in 97.0% of cases. Main non-fatal complications were hematoma (2.4%). In-hospital mortality-rate was 1.2%, and one-year mortality-rate was 1.6%. CONCLUSION: PCI is performed in Subsaharan Africa with safety, despite encountered difficulties in its implementation.
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Síndrome Coronario Agudo/mortalidad , Síndrome Coronario Agudo/terapia , Intervención Coronaria Percutánea , Côte d'Ivoire , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , StentsRESUMEN
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) or sudden death, which typically affects young women. We reported two cases of black Africans patients, aged 56 and 52 years old, who presented to Abidjan Heart Institute for ACS. Coronary angiography showed spontaneous dissection of the right coronary artery in the first case, and dissection of the distal left anterior descending artery in the second. A conservative approach was preferred. Both patients received antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors and statins, with a favorable in-hospital course. These cases highlight SCAD as a possible cause of ACS. Implementation of interventional cardiology in Sub-Saharan Africa will help identify this uncommon cause of ACS.
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Síndrome Coronario Agudo/etiología , Disección Aórtica/complicaciones , Aneurisma Coronario/complicaciones , Síndrome Coronario Agudo/tratamiento farmacológico , Antagonistas Adrenérgicos beta/administración & dosificación , Antagonistas Adrenérgicos beta/uso terapéutico , Disección Aórtica/diagnóstico por imagen , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Aneurisma Coronario/diagnóstico por imagen , Angiografía Coronaria , Complicaciones de la Diabetes , Quimioterapia Combinada , Femenino , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Masculino , Persona de Mediana Edad , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/uso terapéutico , Rotura Espontánea , FumarRESUMEN
AIM: Assess prevalence of metabolic syndrome (MetS) in black Africans hypertensive patients. POPULATION: Prospective survey from 3rd November 2014 to 12th June 2015, at Abidjan Heart Institute. Study was carried out among patients aged 18 years old, admitted to external consultation. Oral consent was obtained. MetS was established based on the definitions of the NCEP-ATP III 2005 and the International Diabetes Federation (IDF). RESULTS: Over 1246 hypertensive patients, 404 were included in our study. The prevalence of MetS was 48.8% according to the criteria of the NCEP-ATP III 2005 and 51% according to the IDF. We noticed a female predominance (69% against 31%, P<0.001). Central obesity (49.5%) and low HDL-cholesterol (42.1%) were the factors defining the SM most predominant in our series. Low blood pressure control was higher in the presence of MetS (43.6%). The average number of antihypertensive prescribed drugs were significantly higher (2.2±0.8 against 2±0.8, P<0.001). MetS was significantly associated with obesity (BMI≥30kg/m(2) : 40.6% against 14%, P<0.001). Cardiovascular complications were observed in 54.8% of hypertensive patients in the presence of MetS. CONCLUSION: MetS is a reality in sub-Saharan Africa. Adequate preventive measures are needed to limit its progression.
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Hipertensión/epidemiología , Síndrome Metabólico/epidemiología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto , Anciano , Índice de Masa Corporal , Côte d'Ivoire/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Hipertensión/etiología , Hipertensión/prevención & control , Masculino , Síndrome Metabólico/complicaciones , Persona de Mediana Edad , Obesidad Abdominal/epidemiología , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Distribución por SexoRESUMEN
We report the case of a young adult admitted to the Abidjan Heart Institute for coronary angiography to explore unstable angina. Coronary angiography showed multiple aneurysms which suggested sequelae of misdiagnosed Kawasaki disease.
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Aneurisma Coronario/etiología , Síndrome Mucocutáneo Linfonodular/complicaciones , Adulto , Aneurisma Coronario/diagnóstico por imagen , Angiografía Coronaria , Côte d'Ivoire , Diagnóstico Diferencial , Humanos , Masculino , Síndrome Mucocutáneo Linfonodular/diagnóstico por imagenRESUMEN
AIM: To assess prevalence, characteristics and management of acute coronary syndromes in sub-Saharan Africa population. PATIENTS AND METHODS: Prospective survey from January, 2010 to December, 2013, carried out among patients aged 18 years old, admitted to intensive care unit of Abidjan Heart Institute for acute coronary syndrome (ACS). RESULTS: Four hundred and twenty-five (425) patients were enrolled in this study. Prevalence of ACS was 13.5%. Mean age was 55.4±11 years. Clinical presentation was predominantly ST-segment elevation myocardial infarction (STEMI) in 71.5% of subjects, non-ST-segment elevation acute coronary syndrome (NSTE-ACS) accounted for 28.5%. Two hundred and eighty patients (65.9%) were transferred by unsafe transportation. Among the 89 patients admitted within 12hours of the onset of symptoms, primary percutaneous coronary intervention was performed in 20 patients (22.5%), or 6.6% of STEMI as a whole. Twenty-five patients (8.2%) received fibrinolytic therapy with alteplase. In-hospital death rate was 10%. CONCLUSION: The prevalence of acute coronary syndromes is increasing in sub-Saharan Africa. Excessive delays of admission and limited technical facilities are the major difficulties of their management in our regions.
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Síndrome Coronario Agudo/epidemiología , Síndrome Coronario Agudo/terapia , Fibrinolíticos , Intervención Coronaria Percutánea , Activador de Tejido Plasminógeno , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/fisiopatología , Adulto , África del Sur del Sahara/epidemiología , Anciano , Femenino , Fibrinolíticos/uso terapéutico , Sistema de Conducción Cardíaco/fisiopatología , Mortalidad Hospitalaria , Hospitales Urbanos , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/terapia , Intervención Coronaria Percutánea/métodos , Prevalencia , Estudios Prospectivos , Activador de Tejido Plasminógeno/uso terapéutico , Resultado del TratamientoRESUMEN
INTRODUCTION: Sleep apnea syndrome (SAS) is very little described in the hypertensive black African. PURPOSE: To screen sleep apnea syndrome using the rating scale of Epworth daytime sleepiness, and to investigate the determinant factors and to infer therapeutic consequences. METHOD: This is a retrospective and prospective study with descriptive and analytical purpose that focused on 200 hypertensive outpatients of the Cardiology Institute of Abidjan. The primary endpoint studied was the SAS. The diagnostic approach of SAS was performed using the rating scale of Epworth daytime sleepiness. RESULTS: The prevalence of sleep apnea was 45%. The average age of sleep apnea carriers was 56.1 years, with a male predominance (60%). The determinant factors of sleep apnea syndrome were male gender (60% versus 40%, P=0.021), obesity (77.8% versus 62.7%, P<0.0001), diabetes (26.7% versus 15.5%, P=0.5) and dyslipidemia (54.4% versus 27.3%, P=0.0009). Life in urban areas, occupation and smoking were not correlated with SAS in our series. The control of hypertension was better in non-apneic patients compared to apneic patients (63.6% versus 38.9%, P=0.04). The visceral impact of hypertension in apneic patients was highly significant (77.8% versus 41.7%, P=0.014). Therapeutically, it was noted the preferential prescription of combination therapy in apneic patients compared to non-apneic patients (82.3% versus 74.4%).
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Población Negra , Trastornos de Somnolencia Excesiva/diagnóstico , Trastornos de Somnolencia Excesiva/etnología , Hipertensión/diagnóstico , Hipertensión/etnología , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/etnología , Encuestas y Cuestionarios , Adulto , Anciano , Comorbilidad , Côte d'Ivoire , Estudios Transversales , Trastornos de Somnolencia Excesiva/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Apnea Obstructiva del Sueño/epidemiologíaRESUMEN
True pulmonary artery aneurysm (AAP) is rare and represent less than 1% of intra-thoracic aneurysms. We report a case of a AAP in a patient with a likely cor triatrium sinister, with an obstructive membrane responsible for pulmonary hypertension, explaining AAP. The long-term evolution of 17 years is made to an uncomplicated myocardial infarction. The patient died eight months later suddenly probably due to the rupture of the PAA.
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Aneurisma/diagnóstico , Aneurisma/etiología , Corazón Triatrial/complicaciones , Corazón Triatrial/diagnóstico , Infarto del Miocardio/etiología , Arteria Pulmonar , Adulto , Resultado Fatal , Femenino , Humanos , Índice de Severidad de la Enfermedad , Factores de TiempoRESUMEN
INTRODUCTION: Diabetic peripheral arterial disease (PAD) of the lower limbs is underdiagnosed. METHODOLOGY: This was a prospective study conducted over a six-month period from November 2012 to April 2013. A total of 308 diabetic patients were included from three diabetes centers in Abidjan (Ivory Coast). AIM: To screen for PAD of the lower limbs in a diabetic population and to identify the determining factors. RESULTS: Among the 308 patients, the ankle-brachial index (ABI) was<0.9 in 68 (22.07%) patients considered to have PAD; the ABI was>1.3 in 56 (18.2%) patients who had suspected mediacalcosis. The average age of the PAD patients was 60.2 years. Female gender predominated (55.9%). The mean duration of diabetes was 9.6 years: 97.1% type 2 diabetes. The other cardiovascular risk factors in this population were hypertension (58.8%) and dyslipidemia (40.9%). Smoking was present in 29.4% of patients and obesity in 23.9%. PAD of the lower limbs was mild in 46 patients (67.6%), moderate in 16 (23.5%) and severe in 6 (8.8%). Duplex Doppler commonly showed lesions of the tibial arteries. Determining factors of diabetic PAD of the lower limbs were hypertension (58.8% vs 36.6%; OR=2.46; 95% CI: 1.13-5.36; P=0.034) and dyslipidemia (40.9% vs 8.3%; OR=7.6; 95% CI: 2.31-25.08; P=0.0009). For mediacalcosis, male gender (71.5% vs 39.7; OR=0.26 95% CI/0.10-0.64. P=0.004) was the only factor identified. CONCLUSION: Hypertension and dyslipidemia were predictive factors for diabetic PAD of the lower limbs in our African population.
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Población Negra , Complicaciones de la Diabetes/diagnóstico por imagen , Angiopatías Diabéticas/diagnóstico por imagen , Pierna/irrigación sanguínea , Enfermedad Arterial Periférica/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Índice Tobillo Braquial , Calcinosis/diagnóstico por imagen , Côte d'Ivoire , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Humanos , Hiperlipidemias/complicaciones , Hipertensión/complicaciones , Artropatías/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Fumar/efectos adversos , Túnica Media , Ultrasonografía , Enfermedades Vasculares/diagnóstico por imagenRESUMEN
The purpose of this report is to present a case involving a tumor-like mass in the left atrium of a 27-year-old woman in Abidjan, Ivory Coast. The mass was discovered by echocardiography carried out after cardiomegaly was detected by roentgenography performed in the context of debilitated general condition, fever and positive serology for HIV1. The patient responded favorably to anti-tuberculosis treatment with complete regression of the mass and improvement of general condition. Based on this outcome, the most likely diagnosis was cardiac tuberculoma, a rare complication of tuberculosis.
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Atrios Cardíacos/microbiología , Tuberculosis Cardiovascular/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Adulto , Antituberculosos/uso terapéutico , Electrocardiografía , Femenino , Infecciones por VIH/complicaciones , Humanos , Taquicardia Sinusal/etiología , Tuberculosis Cardiovascular/tratamiento farmacológicoRESUMEN
The authors report two cases of unusual venous thrombosis associated with protein S deficiency in patients with the acquired immunodeficiency syndrome. The first case was a superior mesenteric vein thrombosis caused by HIV-1 infection associated with protein S deficiency in a 53-year-old patient. The second case was a cerebral venous thrombosis in a 34-year-old patient with HIV-1 and HIV-2 infections associated with protein S deficiency. None of the two patients were receiving antiretroviral therapy at the time of diagnosis. The evolution of thrombosis was favorable in both patients with heparin therapy and antivitamin K (AVK).
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Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Deficiencia de Proteína S/complicaciones , Deficiencia de Proteína S/diagnóstico , Trombosis de la Vena/etiología , Síndrome de Inmunodeficiencia Adquirida/diagnóstico por imagen , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Adulto , Anticoagulantes/uso terapéutico , VIH-1/aislamiento & purificación , VIH-2/aislamiento & purificación , Humanos , Masculino , Venas Mesentéricas/diagnóstico por imagen , Persona de Mediana Edad , Deficiencia de Proteína S/diagnóstico por imagen , Deficiencia de Proteína S/tratamiento farmacológico , Radiografía , Seno Sagital Superior/diagnóstico por imagen , Resultado del Tratamiento , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/tratamiento farmacológicoRESUMEN
UNLABELLED: Hypertension is increasing in sub-Saharan Africa. It is difficult to follow a correct treatment in this environment. PURPOSE: Assessing the compliance of the drug therapy and identifying the characteristics of poor observant patients. METHODS: A study was carried out over one month at the outpatient department of the Abidjan Heart Institute among 200 sub-Saharan African hypertensives. Their compliance was estimated with the Compliance Evaluation Test of Girerd. RESULTS: The average age of the patients was 59 years and 59.5% of them were women. Most patients (60%) had a monthly pay lower than 100,000 CFA (Euros 152). Sixty two percent had no medical insurance. So 175 patients (87.5%) had difficulties to follow their treatment. Among them 55% had a very bad compliance and 32.5% had minor difficulties. Only 12.5% of them had a right compliance. A bad compliance was frequent between 30 and 70 years, in women (60.5%), in unemployed patients (93.7%), in married women (68.7%) and in executives (50%). Other factors of a poor compliance was a monthly income lower than 100,000 FCFA (64%), a number of daily tablets higher than three (77.3%), a number of daily administration >or= $ 3 (95.7%) and the high cost of drugs. A bad compliance is more frequent when herbal treatment is associated with medical drugs or used separately. CONCLUSION: The compliance of the antihypertensive treatment was poor. The causes are numerous, but they are very often related with the growing poverty in the black society.