title: [Acute myocardial infarction in Djibouti: 2-year prospective study].
abstract: OBJECTIVE
  Acute myocardial infarction (AMI) is a life-threatening emergency. In Africa, the increasing prevalence of cardiovascular risk factors is leading to an epidemiological transition. No data have yet been reported about AMI in Djibouti.
  
  
  METHODS
  This study prospectively included all patients with acute coronary syndrome and persistent ST segment elevation admitted to the emergency department of Bouffard Military Hospital in Djibouti from January 2009 through December 2010. It analyzed their clinical data and management.
  
  
  RESULTS
  The study included 35 patients. Their mean age was 52 ± 11 years [range: 29-76]. The sex ratio was 7.7 (men/women). Cardiovascular risk factors were: hypercholesterolemia (83%), tobacco use (60%), khat chewing (57%), diabetes (49%), hypertension (46%), and heredity (20%). AMI was anterior in 40% of cases. Fifteen patients (43%) arrived within 12 hours after the onset of symptoms (average 5 hours); thrombolysis was successful for 11 of them (73%). Seven patients (20%) died over the entire follow-up (11.3 ± 9 months), 5 within the first month. Mortality was significantly associated with diabetes (p<0.01), initial severe clinical complications (p<0.01) and initial low left ventricular ejection fraction (p<10(-6)).
  
  
  CONCLUSIONS
  Patients with AMI in Djibouti are 10 to 15 years younger than in Western countries. Their high level of cardiovascular risk is remarkable. Khat use did not significantly affect prognosis. The high mortality rate was similar to rates reported before the percutaneous coronary angioplasty era.
authors.affiliation: Hôpital médicochirurgical Bouffard, Djibouti. olgamaurin@free.fr
authors.forename: O
authors.initials: O
authors.lastname: Maurin
authors.forename: P L
authors.initials: PL
authors.lastname: Massoure
authors.forename: S
authors.initials: S
authors.lastname: de Regloix
authors.forename: F
authors.initials: F
authors.lastname: Topin
authors.forename: F
authors.initials: F
authors.lastname: Sbardella
authors.forename: G
authors.initials: G
authors.lastname: Lamblin
authors.forename: E
authors.initials: E
authors.lastname: Kaiser
mesh_terms: D000328:Adult; D000368:Aged; D015730:Djibouti / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D013997:Time Factors