ABSTRACT
BACKGROUND: Diabetes can lead to micro and macro-angiopathies. The peripheral arterial disease (PAD) is a serious and an incapacitating disease. It is still under-estimated and under-treated throughout the world, particularly in sub-Saharan Africa. Doppler ultrasound, and in particular ankle brachial index (ABI), can be used to detect it. The aim was to determine the prevalence of PAD to study the clinical and ultrasonographic aspects and to identify the determining factors. PATIENTS AND METHODS: This was a descriptive and analytical study over a period of 5 years, including a total of 782 diabetic patients hospitalised in the diabetology department of the CHU la Reference Nationale. RESULTS: Among the 782 patients, 166 (21.2%) had an ABI < 0.9 reflected the PAD and 72 (9.2%) had an ABI > 1.3, suggestive of mediacalcosis. PAD of the lower limb was mild in 102 patients (61.4%), moderate in (26.3%) and severe in (12.3%). The mean age of the arteritic patients was 56.4 ± 10.2 years. Male gender predominated (59.6%) with a sex ratio of 1.6. All patients had type 2 diabetes (100%). The mean duration of diabetes was 13 ± 5.9 years. The majority of our patients with arterial disease had diabetes for at least 10 years (54.2%). The other cardiovascular in this population were obesity (45.2%), followed by hypertension and dyslipidaemia (32.5%). Diabetes was unbalanced (HbA ≥7%) in the majority of cases (75.3%). Clinically, the majority of patients had a trophic disorder (68%). Asymptomatic patients accounted for 24.6% of cases and those with intermittent claudication for 7.4%. Duplex doppler of the lower limbs showed that all patients with PAD had atheromatous lesions. The distal location was predominantly in the tibial arteries (54.8%). The determinants of PAD in this diabetic population were hypertension (p = 0.01) and obesity (p = 0.01). CONCLUSION: In our series, PAD was often discovered at an advanced stage, with a non-negligible prevalence. The determining factors found were hypertension and obesity. Screening and control of major cardiovascular risk factors is a priority in the management of this disease.
Subject(s)
Peripheral Arterial Disease , Humans , Male , Female , Middle Aged , Peripheral Arterial Disease/epidemiology , Peripheral Arterial Disease/diagnostic imaging , Prevalence , Aged , Black People/statistics & numerical data , Ankle Brachial Index , Risk Factors , Adult , Diabetic Angiopathies/epidemiology , Diabetic Angiopathies/diagnostic imaging , Diabetes Mellitus, Type 2/complications , Ultrasonography, DopplerABSTRACT
Contexte et objectif. En Afrique, l'augmentation de la fréquence des facteurs de risque cardiovasculaires est responsable d'une transition épidémiologique. L'objectif de cette étude était de décrire les profils des syndromes coronariens aigus (SCA) au Centre Hospitalo-Universitaire la Renaissance (CHUR). Méthodes. Il s'agissait d'une étude documentaire descriptive, du 1er janvier 2014 au 31 décembre 2018, ayant inclus 96 dossiers des patients hospitalisés pour SCA dans le service de cardiologie au CHUR. Les données ont été collectées à l'aide des fiches préétablies. Nous avons étudié les caractéristiques sociodémographiques, électrocardio-graphiques, échocardiographies, thérapeutiques et évolutives des participants. Résultats. La fréquence du SCA était de 9,41%. Le sex ratio H/F était de 1,2. L'âge moyen était de 61,3 ± 5,2 ans. Les antécédents les plus représentés étaient les cardiopathies ischémiques (56,25 %). L'hypertension artérielle était le facteur de risque prédominant avec 71,88% des cas. Le principal motif de consultation était la douleur thoracique (81,25%) et le délai d'admission était au-delà 12 heures dans 79,17% des cas. L'analyse de l'électrocardiogramme a permis d'identifier 59% du SCA avec sus ST et 41% du SCA sans sus ST. La dysfonction ventriculaire gauche était observée chez 36,46% de nos patients. Seuls 7,29 % des patients avaient reçu un traitement thrombolytique. La durée d'hospitalisation moyenne était de 5,8 ± 0,53 jours et la mortalité intrahospitalière était à 15,63%. Conclusion. Dans cette étude, les patients atteints de SCA présentent plusieurs facteurs du risque cardiovasculaires. Le délai d'admission est tardif et le taux de revascularisation durant la phase aigüe est faible
Context and objective. In Africa, the increase in the frequency of cardiovascular risk factors is responsible for an epidemiological transition. The objective of this study was to describe the pattern of acute coronary syndromes (ACS) at the Renaissance University Hospital Center (RUHC). Methods. A descriptive retrospective study was carried out from January 1st, 2014 to December 31st, 2018 on medical records from patients hospitalized for ACS in the Department of Cardiology at the RHUC. Data was collected using pre-established forms. Socio-demographic, electrocardiographic, echocardiographic, therapeutic and evolutionary characteristics of the participants were studied. Results. Medical records from 96 patients hospitalized for ACS were included in the present study. The frequency of ACS was 9.41%. The sex ratio M / F was 1.2. The mean age was 61.3 ± 5.2 years. The most common history was ischemic heart disease (56.25%). High blood pressure was the predominant risk factor with 71.88% of cases. The main reason for consultation was chest pain (81.25%) and the time to admission was beyond 12 hours in 79.17% of cases. the electrocardiogram analysis identified 59% of ACS with sus ST and 41% of ACS without sus ST. Left ventricular dysfunction was observed in 36.46% of our patients. Only 7.29% of patients had received thrombolytic therapy. The mean hospital stay was 5.8 ± 0.53 days and the inhospital mortality was 15.63%. Conclusion. In this study, patients with ACS had several cardiovascular risk factors. The time to admission is late and the rate of revascularization during the acute phase is low.
Subject(s)
Health Profile , Acute Coronary Syndrome , ChadABSTRACT
Introduction. L'insuffi sance mitrale ischémique est une complication fréquente et représente un facteur de mauvais pronostic. Sa prise en charge thérapeutique est diffi cile. L'objectif de ce travail est de réévaluer l'intérêt de la revascularisation par angioplastie en cas d'insuffi sance mitrale ischémique importante. Observation et conclusion. Nous rapportons le cas d'un patient âgé de 48 ans ayant comme facteurs de risque cardiovasculaire ; une hypertension artérielle non suivie et un tabagisme actif (20 Paquets/année) qui s'était présentait pour un syndrome coronaire aigu compliqué d'une insuffi sance mitrale sévère et d'une insuffi sance cardiaque gauche avec une altération de la fraction d'éjection ventriculaire gauche à l'échocardiographie. La coronarographie montrait une atteinte tritronculaire. La revascularisation complète par angioplastie a permis une bonne évolution à cinq (5) ans