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AFRICA
Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S14
Evaluation of the therapeutic observance of outpatients with hypertension at the Cardiology Department of Grand Yoff
General Hospital in Dakar, Senegal
Ngone Diaba Gaye*, Aliou Alassane Ngaide
#
, Maimouna Sow
†
, Momar Dioum
◊
, Fatou Aw
†
, Serigne Mor Beye
§
, Salimatou Dela Diallo
#
, Cheikh Gaye
#
,
Joseph Salvador Mingou
†
, Simon Antoine Sarr
†
and Alassane Mbaye
#
*Medico-Social Foresight Institute, Cheikh Anta Diop University, Dakar, Senegal.
#
General Hospital of Grand Yoff, Dakar, Senegal.
†
Aristide Le Dantec Hospital,
Dakar, Senegal.
◊
FANN National Hospital, Dakar, Senegal.
§
Saint Louis General Hospital, Dakar, Senegal
Introduction:
Hypertension is a global public health problem and one of the leading causes of early death worldwide. Non-adherence remains a real
problem in the management of high blood pressure. The aim of this study was to evaluate the determinants of therapeutic observance in hypertensive
patients at Grand Yoff General Hospital.
Methods:
This was a cross-sectional study, from 7 August 2017 - 6 October 2017, of outpatients at the Grand Yoff General Hospital cardiology department.
Therapeutic compliance was assessed using the Girerd compliance assessment test which consisted of 6 questions which patients had to answer with yes or
no. Data collection was done using the Sphins V.5 software. A value of p less than 0.05 was considered significant.
Results:
Ninety-nine patients were enrolled. The mean age was 61.4 ± 11.6 years with extremes of 25.0 and 82.0 years. The sex ratio H/F was 0.5. Prevalence
of tobacco and alcohol consumption was respectively 4% and 5%. Average body mass was 26.6 ± 5.9kg/m² and 73.7% of patients had a sustainable physical
activity. Mean systolic blood pressure was 150 ± 20mmHg. Mean diastolic blood pressure was 88 ± 12mmHg. A total of 74.7% of patients followed a salt
restricted diet. Blood pressure was controlled in 35.4% of patients. Other cardiovascular risk factors were: dyslipidemia (49.5%), obesity (26%) and diabetes
(21%). A total of 54.6% patients had compliance issues and 9.1% were poor observers.
Conclusion:
Improving adherence to treatment in our context requires better education of patients and the implementation of a specific national
programme for the control of blood pressure.
Pattern of coronary artery disease in Black African women: About 92 cases
Ngone Diaba Gaye*, Fatou Aw
#
, Simon Antoine Sarr
#
, Aliou Alassane Ngaide
†
, Momar Dioum
‡
, Mouhamadou Bamba Ndiaye
#
, Maboury Diao
#
,
Serigne Cheikh Ndao
◊
and Serigne Abdou Ba
#
*Medico-Social Foresight Institute, Cheikh Anta Diop University, Dakar, Senegal. #Aristide Le Dantec Hospital, Dakar, Senegal. †General Hospital of Grand Yoff,
Dakar, Senegal.
‡
FANN National Hospital, Dakar, Senegal.
◊
Principal Military Hospital, Dakar, Senegal
Introduction:
To study the prevalence and pattern of CAD among women undergoing CAG in Dakar.
Methods:
Data of 92 women who underwent CAG for suspected CAD over 3 years were retrospectively analysed. They were classified into a young group
(age <55 years) and elderly group (age ≥55 years).
Results:
Overall, prevalence of obstructive coronary artery disease was 53.3%. Multivessel disease was found in 35.9% of cases. There was a greater prevalence
of obstructive CAD (35 vs. 14; p=0.51), especially double vessel and triple vessel disease in the elderly group while normal coronaries were more prevalent in
the young group. The prevalence of LMD was 4.4% and exclusively found in elderly women. The pattern of involvement of coronary arteries was the same for
both groups; left anterior descending artery was the most commonly affected vessel.
Conclusion:
This study demonstrates that CAD is present in groups, such as young women, not previously considered at risk.
CAMISSA: The contemporary study of acute myocarditis in sub-Saharan Africa
Karim Hassan*, Philip Herbst*, Anton Doubell*, Dan Zaharie*, Gert Van Zyl
#
and Charles Kyriakakis*
*Division of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Bellville,
South Africa.
#
National Health Laboratory Services, Johannesburg, Gauteng, South Africa.
Introduction:
The aetiology and estimated incidence of acute myocarditis (AM) remains undefined in Africa. Whilst cardiac magnetic resonance (CMR)
provides a provisional non-invasive diagnosis, endomyocardial biopsy (EMB) remains the gold standard. The developed world has experienced a shift in the
viral epidemiology of AM and the European Society of Cardiology’s most recent position statement on myocarditis recommends both CMR and EMB as the
standard of care in suspected cases. We report on the interim results of the study.
Methods:
A cohort of patients from a single tertiary centre in South Africa will be recruited from January 2018 - December 2022. All patients presenting
or referred to the centre with clinically suspected AM will be investigated according to ESC recommendations on myocarditis. This includes blood
tests (inflammatory markers, cardiac enzymes, HIV and hepatitis C serology and ANA in females), a standard 12-lead electrocardiogram, transthoracic
echocardiography, coronary angiography, CMR and EMB. Enrolment is ongoing.
Results:
A total of 48 (mean age 41.3 ± 13.3 years, 65.3% male) clinically suspected cases of AM were identified between January 2018 and June 2019.
Twenty-six patients presented with symptoms of ACS, 16 with heart failure, 4 with ventricular tachycardia and 2 with heart block. At index presentation, 33
had an elevated hs–Trop T. CRP was elevated in 20 of these patients and in isolation in another 6. Thirty-three patients met the Lake Louise criteria on CMR, of
which 5 fulfilled the Dallas criteria and 15 the immunohistochemical criteria on EMB. Eight CMR negative cases were found to have AM on EMB. Twenty-nine
were PCR positive for cardiotropic viruses.
Conclusion:
This study demonstrates the heterogeneity in presentations and provides insight into the possible viral pathogens within our local setting. This
appears to be similar to those reported in the developed world. To our knowledge, this is the first study to evaluate AM in Africa.