Authors: Momar Dioum, Papa Nguirane Ndiaye, Fatou Aw, Joseph Salvador Mingou, Mouhamadou Bamba Ndiaye, Simon Antoine Sarr, Malick Bodian, Aliou Alassane Ngaïdé, Alassane Mbaye, Bouna Diack, Maboury Diao, Abdoul Kane, Serigne Abdou Ba.
Background: Myocardial infarction has benefited from therapeutic progress but, it remains a major public health problem. Coronary angioplasty is the treatment of choice. The objective of this study was to evaluate the results of angioplasty in acute coronary syndrome with persistent ST segment elevation (STEMI).
Methodology: We conducted a prospective, descriptive and analytical study from January 1st, 2017 to March 31st, 2018. All patients admitted for STEMI who underwent coronary angioplasty were included.
Results: Fifty-four patients were included with a mean age of 59 years. There was a male predominance with a sex ratio of 2.3. Patient’s cars were the main means of transport (n=29, 53.7%). A sedentary lifestyle was frequently found (75.9%). Chest pain included: typical (n = 45, 83.3%) and atypical (n=9, 16.7%). The mean time between the onset of the pain and the completion of an electrocardiogram was 7h 19 min. All patients had a subepicardial lesion with anterior territory predominance in 32 patients (62.8%). The right radial access was mostly used (n=30, 55.6%). The anterior interventricular artery was the most affected branch (n=31, 57.4%). The artery was occluded (TIMI grade 0 in fourteen patients). The treatment included: primary angioplasty (n=10, 18.5%), rescue angioplasty (n=11, 20.4%), and delayed angioplasty in the majority of cases (61.2%). Direct stenting was performed in 23 patients and 30 patients had balloon pre-dilatation. Active stent was the most used (n=33). A successful angioplasty was obtained in 49 patients (90.7%) with a TIMI grade 3. Three cases of thrombotic occlusion were noted per procedure and one case of coronary dissection. Short-term evolution was marked by 3 cases of death caused by cardiogenic shock (n=1) and intrastent restenosis (n=1).
Conclusion: Angioplasty is the treatment of choice of acute coronary syndromes. But in our context, his current practice is hampered by the delay in diagnosis, the patient transfer time and the availability of the catheterization rooms.
View/Download pdf