Cardiology & Vascular Research

Abstract

Comparative Study of Coronary Disease in Women and Man in Sub- Saharan Africa

Dioum Momar, Ndiaye MB, Benaammouch S, Mingou JS, AW F, SARR SA, Ngaide AA, Bodian M, Diack B, Diao M, Mbaye A, Kane A, Ba S.

Introduction: Coronary artery disease is considered to be a male disease because of its clinical, paraclinical and therapeutic aspects compared for both sexes, yet it is the leading cause of death in women. Our study was done in order to do the comparison.

Methodology: We compared the data of patients who underwent coronary angiography or percutaneous coronary intervention at the cardiology clinic of Aristide Le Dantec hospital over a period of 6 months.

Results: Our study included 131 patients, with 91 men and 40 women, and a sex ratio (M/F) of 2.27. Women were older than men (59.27 ± 10.31 years old compared with 57.86 ± 11.63 years, p=0.229). A comparison of the frequency of risk factors for atherosclerosis in both sexes led to a higher co-morbidity in women (p=0.005). Women had more atypical pain than men, ie 62.5% versus 28.52% (p=0.0001). Non-ST elevation myocardial infarction were less common in women 37.5% than in men 51.65% (p=0.135). On the other hand, non-ST elevation myocardial infarction predominated in women 30% vs 13.9% (p=0.062). Coronary angiography showed a predominance of mono-vessel coronary artery disease in men 31.8% vs. 25%, (p=0.53) and three-vessel coronary artery disease in women 37.5% vs 31.8% (p=0.61). Twenty-one patients had thrombolysis, including 18 men and 3 women (p=0.192). Primary percutaneous coronary intervention was performed in 4.4% of men and 5% of women, respectively (p=0.87). Women had less benefited from programmed percutaneous coronary intervention, ie 22.5% against 27.47% (p=0.54).

Conclusion: Our study shows that women with coronary artery disease are older and have many factors. The clinical presentation is often atypical hence a delay in diagnosis compared to men. They have more severe coronary artery disease and benefit from less aggressive treatment strategy.

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