Stable Angina Pectoris: Epidemiological, Clinical, Paraclinical and Angiographic Aspects in A Patients Cohort in Saharan Sub-Africa

Abstract

  Context and Purpose: Stable angina is one of the first manifestations or warning signs of underlying coronary disease. However we have very few studies on this pathology in sub-Saharan African population. Therefore we aimed to study the epidemiological, clinical, paraclinical and angiographic aspects o in a cohort of patient who were referred in two hospitals for diagnostic coronary artery because of suspected stable coronary disease. Methods: We conducted a prospective, descriptive and analytical study from March 01, 2019 to December 31, 2020 on a cohort of patients admitted to the Cardiology Departments of Idrissa Pouye General Hospital and Aristide Le Dantec National University Hospital Center of Dakar for diagnostic CAD because of suspected stable coronary disease. Results: During the study period, 143 patients were selected. The mean age was 60.91± 10.58 years, with extremes of 28 and 81 years. The most represented age group was between [60-69] years with 55(38.5%) patients; men were 96(67.13%) and women 47(32.87%); sex ratio M/F was 2.04. The most observed symptoms were atypical angina and typical angina with respectively 49.65% (n=71) and 37.76% (n=54). Only one (1) patient presented with non-anginal chest pain. Hypertension was the predominant cardiovascular risk factor, with 60.84% (n=87) of cases; followed by diabetes 34.27% (n=49); dyslipidemia 32.17% (n=46) and physical inactivity 26.57% (n=38). The presentation of stable angina was dominated by ST segment sub-shift and negative T waves with 23.07% (n=33) and 24.47% (n=35) respectively. Hypokinesia was the most significant segmental kinetic disorder with a prevalence of 22.38% (n=32). Coronary angiography revealed that 59 patients (41.26%) had normal coronary angiography; 27patients (18.88%) had single vessel-disease; 28 (19.58%) had double vessel-disease and 29 (20.28%) triple vessel-disease. Angiographic findings showed a predominance of tight lesions with 44.98% (n=157); the anterior interventricular artery was the most affected artery with 38.68% (n=135). Out of 84 patients with obstructive coronary artery disease, 37 (44.05%) had recommended for angioplasty and 47 (55.95%) for medical management only. There was no death during the procedure. Conclusion: Our study shows that stable angina is characterized by a relatively early age of onset, atypical pains, patients with multiple risk factors; more than half of our study population (58.74%) had obstructive coronary artery disease. Therefore, it is urgent to further strengthen strategies for early detection and effective primary prevention against cardiovascular risk factors.