Prevalence, Presenting Complaints, Risk Factors and Comorbidity of Acute Coronary Syndrome at Orotta National Referral Hospital Intensive Care Unit Eritrea: Retrospective Study
Science Journal of Public Health
Volume 5, Issue 6, November 2017, Pages: 457-463
Received: Oct. 10, 2017;
Accepted: Nov. 7, 2017;
Published: Nov. 17, 2017
Views 1764 Downloads 59
Elias Teages Adgoy, Department of Community Medicine and Primary Health Care, Orotta School of Medicine and Dentistry, Asmara, Eritrea
Yemane Seyoum, Department of Internal Medicine, Orotta School of Medicine and Dentistry, Asmara, Eritrea; Ministry of Health, Orotta National Referral Hospital, Asmara, Eritrea
Abiel Berhe, Ministry of Health, Orotta National Referral Hospital, Asmara, Eritrea
Yoseph Tewolde, Department of Surgery, Orotta School of Medicine and Dentistry, Asmara, Eritrea; Ministry of Health, Orotta National Referral Hospital, Asmara, Eritrea
Fitsum Kibreab, Ministry of Health, Asmara, Eritrea
Coronary Heart Disease (CHD) being one of the major manifestations of atherosclerotic cardiovascular disease, it ranks a third for all deaths above the age of 35 in developed countries. It is the principal cause of mortality globally for greater than 4.5 million people in the developing world with a relative lack of preventive measures implemented. Eighty percent of deaths due to Cardiovascular Diseases (CVD) occur in developing countries. CHD rates are expected to increase in developing countries mainly South East Asia, Sub-Saharan Africa, Latin America, and the Middle East; from 9 million in 1990 to 19 million by 2020. This Retrospective study was carried out to assess the Prevalence, Presenting Complaints, Risk factors and Comorbidity of Acute Coronary Syndrome (ACS) at Orotta National Referral Hospital Intensive Care Unit, Asmara, Eritrea. Hospital based Retrospective record review study of ten years was done on clinical cards of patients. The study results revealed an overall prevalence of 8.5 percent. ACS was observed to increase with an increasing age, being higher in 164 patients (55%) who are in the age group greater than sixty. Majority (86.6%) of admissions were reported as from zoba Maekel. It was observed to increase in males than females with 3.66 to 1 ratio of male to female. Chest pain was documented as a chief complaint (85.23%). The average length of hospital stay until discharged or death was found to be 11 days. Comorbidity between Hypertension, Diabetes and ACS was documented as 55.4 percent showing a significant association (P Value= 0.001). The study results also revealed a significant association between sex and, NSTEMI and STEMI at a P- value = 0.003, but no any association was found among NSTEMI and STEMI, and age, smoking, cholesterol level, Diabetes and Hypertension. In conclusion, this study revealed that ACS is increasing in Eritrea as any other developed and developing countries. The association between sex and, NSTEMI and STEMI which may be attributed to modifiable behavioral risk factors that are gender related. Therefore, the study recommends to Clinicians to ask and record, family history of premature CHD death, duration of Diabetes, Hypertension and other chronic cardio-pulmonary diseases, all diagnostic investigations and specific medications that are used for the management of the disease and good outcome.
Elias Teages Adgoy,
Prevalence, Presenting Complaints, Risk Factors and Comorbidity of Acute Coronary Syndrome at Orotta National Referral Hospital Intensive Care Unit Eritrea: Retrospective Study, Science Journal of Public Health.
Vol. 5, No. 6,
2017, pp. 457-463.
Roger, V. L., et al., Executive Summary: Heart Disease and Stroke Statistics--2011 Update: A Report From the American Heart Association. Circulation, 2011. 123(4): p. 459.
Okrainec K, Banerjee DK, Eisenberg MJ. Coronary artery disease in the developing world. American heart journal. 2004 Jul 31; 148(1):7-15.
Bitton A, Gaziano T. The Framingham Heart Study's impact on global risk assessment. Progress in cardiovascular diseases. 2010 Aug 31; 53(1):68-78.
Ergin A, Muntner P, Sherwin R, He J. Secular trends in cardiovascular disease mortality, incidence, and case fatality rates in adults in the United States. The American journal of medicine. 2004 Aug 15; 117(4):219-27.
Walker AR, Sareli P. Coronary heart disease: outlook for Africa. Journal of the Royal Society of Medicine. 1997 Jan; 90(1):23-7.
Onen CL. Epidemiology of ischaemic heart disease in sub-Saharan Africa. Cardiovascular journal of Africa. 2013 Mar 1; 24(2):34-42.
Hertz JT, Reardon JM, Rodrigues CG, de Andrade L, Limkakeng AT, Bloomfield GS, Lynch CA. Acute myocardial infarction in sub-Saharan Africa: the need for data. PloS one. 2014 May 9; 9(5):e96688.
Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. The lancet. 2004 Sep 17; 364(9438):937-52.
Steyn K, Sliwa K, Hawken S, Commerford P, Onen C, Damasceno A, Ounpuu S, Yusuf S. Risk factors associated with myocardial infarction in Africa. Circulation. 2005 Dec 6; 112(23):3554-61.
Joseph VA. Frequency and Pattern of Acute Myocardial Infarction in the University of Benin Teaching Hospital, Nigeria. Nigerian Medical Practitioner. 2009; 55(6).
Seyoum Y, Leake N. Clinical features of acute myocardial infarction: A report from Halibet Referral Hospital in Eritrea. Journal of the Eritrean Medical Association. 2006; 1(1).
World Health Organization. Noncommunicable diseases country profiles 2014. 2014.
Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Writing Group on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, Authors/Task Force Members Chairpersons, Thygesen K, Alpert JS, White HD. Third universal definition of myocardial infarction. European heart journal. 2012 Aug 24; 33(20):2551-67.
Mendis S, Thygesen K, Kuulasmaa K, Giampaoli S, Mähönen M, Ngu Blackett K, Lisheng L, Writing group on behalf of the participating experts of the WHO consultation for revision of WHO definition of myocardial infarction. World Health Organization definition of myocardial infarction: 2008–09 revision. International journal of epidemiology. 2010 Oct 4; 40(1):139-46.
Shavadia J, Yonga G, Otieno H. A prospective review of acute coronary syndromes in an urban hospital in sub-Saharan Africa: cardiovascular topics. Cardiovascular journal of Africa. 2012 Jul 1; 23(6):318-21.
MOH. Eritrea & WHO. NATIONAL NON COMMUNICABLE DISEASE (NCD) RISK FACTOR BASELINE SURVEY (USING WHO STEP Swise APPROACH), 2004.
MOH. Eritrea & WHO. National STEPS Survey for Chronic Non-Communicable Diseases and their Risk Factors. 2012.
Moran AE, Forouzanfar MH, Roth G, Mensah GA, Ezzati M, Flaxman A, Murray CJ, Naghavi M. The global burden of ischemic heart disease in 1990 and 2010: the Global Burden of Disease 2010 study. Circulation. 2014 Feb 26: CIRCULATIONAHA-113.
Malik MA, Khan SA, Safdar S, Taseer IU. Chest Pain as a presenting complaint in patients with acute myocardial infarction (AMI). Pakistan journal of medical sciences. 2013 Apr; 29(2):565.
Bramkamp M, Radovanovic D, Erne P, Szucs TD. Determinants of costs and the length of stay in acute coronary syndromes: a real life analysis of more than 10 000 patients. Cardiovascular drugs and therapy. 2007 Oct 1; 21(5):389-98.
Keller T, Tzikas S, Scheiba O, Krahn U, Post F, Arnolds S, Blankenberg S, Warnholtz A, Münzel T, Genth-Zotz S. The length of hospital stay in patients with acute coronary syndrome is reduced by establishing a chest pain unit. Herz. 2012 May; 37(3):301-7.
Willich SN, Müller-Nordhorn J, Kulig M, Binting S, Gohlke H, Hahmann H, Bestehorn K, Krobot K, Völler H. Cardiac risk factors, medication, and recurrent clinical events after acute coronary disease. A prospective cohort study. European Heart Journal. 2001 Feb 1; 22(4):307-13.
Assiri AS. Knowledge about coronary artery disease among patients admitted to Aseer Central Hospital with acute coronary syndrome. West African journal of medicine. 2003; 22(4):314-7.