title: Acute coronary syndrome in young Sub-Saharan Africans: a prospective study of 21 cases.
abstract: BACKGROUND
  Coronary heart disease remains the leading cause of death in developed countries. In Africa, the disease continues to rise with varying rates of progression in different countries. At present, there is little available work on its juvenile forms. The objective of this work was to study the epidemiological, clinical and evolutionary aspects of acute coronary syndrome in young Sub-Saharan Africans.
  
  
  METHODS
  This was a prospective multicenter study done at the different departments of cardiology in Dakar. We included all patients of age 40 years and below, and who were admitted for acute coronary syndrome between January 1st, 2005 and July 31st, 2007. We collected and analyzed the epidemiological, clinical, paraclinical and evolutionary data of the patients.
  
  
  RESULTS
  Hospital prevalence of acute coronary syndrome in young people was 0.45% (21/4627) which represented 6.8% of all cases of acute coronary syndrome admitted during the same period. There was a strong male predominance with a sex-ratio (M:F) of 6. The mean age of patients was 34 ± 1.9 years (range of 24 and 40 years). The main risk factor was smoking, found in 52.4% of cases and the most common presenting symptom was chest pain found in 95.2% of patients. The average time delay before medical care was 14.5 hours. Diagnosis of ST-elevation myocardial infarction in 85.7% of patients and non-ST-elevation myocardial infarction in 14.3% was made by the combination electrocardiographic features and troponin assay. Echocardiography found a decreased left ventricular systolic function in 37.5% of the patients and intraventricular thrombus in 20% of them. Thrombolysis using streptokinase was done in 44.4% of the patients with ST-elevation myocardial infarction. Hospital mortality was 14.3%.
  
  
  CONCLUSIONS
  Acute coronary syndrome is present in young Sub-Saharan Africans. The main risk factor found was smoking.
authors: Moustapha
authors: M
authors: Sarr
authors: Djibril Mari
authors: DM
authors: Ba
authors: Service de Cardiologie, CHU Aristide Le Dantec University Hospital, PO Box 6633, Dakar étoile, Avenue Pasteur, Dakar, Senegal. bambandiaye75@yahoo.fr.
authors: Mouhamadou Bamba
authors: MB
authors: Ndiaye
authors: Malick
authors: M
authors: Bodian
authors: Modou
authors: M
authors: Jobe
authors: Adama
authors: A
authors: Kane
authors: Maboury
authors: M
authors: Diao
authors: Alassane
authors: A
authors: Mbaye
authors: Mouhamadoul Mounir
authors: MM
authors: Dia
authors: Soulemane
authors: S
authors: Pessinaba
authors: Abdoul
authors: A
authors: Kane
authors: Serigne Abdou
authors: SA
authors: Ba
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000208:ethnology* / Q000628:therapy; D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology*; D055815:Young Adult