Type 2 Myocardial Infarction in a Sub‐Saharan Africa Population: Challenging the Current Concepts—Data From REACTIV

From a large observational acute coronary syndrome registry in Côte d'Ivoire, we aimed to assess incidence, clinical presentation, management, and in-hospital outcomes for type 2 myocardial infarction (T2MI) compared with type 1 MI. We conducted a cross-sectional monocentric study using data fr...

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Published in:Journal of the American Heart Association Vol. 13; no. 14; p. e032149
Main Authors: Yao, Hermann, Touré, Camille, Ekou, Arnaud, Sepih, Elvis, Cottin, Yves, Zeller, Marianne, Putot, Alain, N'Guetta, Roland
Format: Journal Article
Language:English
Published: England Wiley-Blackwell 16.07.2024
John Wiley and Sons Inc
Wiley
Subjects:
Aged
Coronary Angiography
coronary artery disease
Cross-Sectional Studies
Female
Hospital Mortality
Hospital Mortality - trends
Humans
Incidence
Life Sciences
Male
Middle Aged
Myocardial Infarction
Myocardial Infarction - diagnosis
Myocardial Infarction - epidemiology
Myocardial Infarction - mortality
Original Research
Registries
Risk Factors
sub‐Saharan Africa
type 1 myocardial infarction
type 2 myocardial infarction
coronary artery disease
sub‐Saharan Africa
type 1 myocardial infarction
type 2 myocardial infarction
ISSN:2047-9980, 2047-9980
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Summary:From a large observational acute coronary syndrome registry in Côte d'Ivoire, we aimed to assess incidence, clinical presentation, management, and in-hospital outcomes for type 2 myocardial infarction (T2MI) compared with type 1 MI. We conducted a cross-sectional monocentric study using data from REACTIV (Registre des Infarctus de Côte d'Ivoire) at the Abidjan Heart Institute. All patients hospitalized with MI between 2018 and 2022 who underwent coronary angiography were included. For each patient, sociodemographic data, cardiovascular risk factors and history, and clinical and paraclinical presentation were collected at admission. In-hospital outcomes, including major adverse cardiovascular events and mortality, were reported. Among 541 consecutive patients hospitalized with MI, 441 met the definition of type 1 MI or T2MI. T2MI accounted for 14.1% of cases. Patients with T2MI showed a trend toward slightly younger age (54 versus 58 years, =0.09). Patients with T2MI seemed to have less severe coronary artery disease, with less frequent multivessel disease ( <0.001). Main triggering factors for T2MI were coronary embolism (24.2%), severe hypertension with or without left ventricular hypertrophy (22.6%), and tachyarrhythmia (16.1%). In-hospital event rates were low in both MI types. Although the difference was nonsignificant, death rates for patients with type 1 MI tended to be higher than for patients with T2MI, as well as occurrence of major adverse cardiovascular events. Our study revealed disparities in clinical characteristics, angiographic features, cause, and in-hospital outcomes in T2MI in our population compared with Western populations. These results suggest the heterogeneity of T2MI and the potential causative and demographic variability depending on geographical area.
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PMCID: PMC11292756
For Sources of Funding and Disclosures, see page 9.
This article was sent to Mahasin S. Mujahid, PhD, MS, Associate Editor, for review by expert referees, editorial decision, and final disposition.
Supplemental Material is available at https://www.ahajournals.org/doi/suppl/10.1161/JAHA.123.032149
This work was presented in part at the Journées Européennes de la Société Française de Cardiologie (JESFC) conference, January 17–19, 2024, in Paris, France.
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.123.032149