Abstract
BACKGROUND: Whereas the increasing burden of acute myocardial infarction (MI) has been reported in sub-Saharan Africa, little is known about short- and long-term prognosis following acute MI. OBJECTIVES: The purpose of this study was to assess in-hospital, 30-day, and 1-year all-cause mortality and adverse outcomes in patients with MI hospitalized at a cardiac center in Côte d'Ivoire. METHODS: This prospective cohort study used data from the REgistre des syndromes coronariens Aigus de CôTe d'IVoire (REACTIV). All consecutive patients admitted to the intensive care unit with acute MI were included. The primary endpoints included in-hospital, 30-day, and 1-year all-cause mortality and major adverse cardiovascular events. Multivariable Cox regression analyses were performed to identify factors associated with 30-day and 1-year all-cause mortality. RESULTS: A total of 272 participants were included (average age 56.93 ± 11.1 years, 76.8% men). The in-hospital mortality was 9.9%. Mortality rates and major adverse cardiovascular events were 11% and 2.8% at 30 days and 21.7% and 27.3% at 1 year, respectively. In the multivariable regression model, factors associated with 30-day all-cause mortality were Killip stage ≥2 at admission (relative risk [RR]: 3.65; 95% CI: 1.61-8.26) and impaired renal function (RR: 3.44; 95% CI: 1.63-7.26). One-year all-cause mortality was associated with Killip stage ≥2 at admission (RR: 2.74; 95% CI: 1.52-4.94), anterior MI (RR: 2.48; 95% CI: 1.37-4.48), impaired renal function (RR: 3.44; 95% CI: 1.63-7.26), and sustained ventricular tachycardia (RR: 5.24; 95% CI: 2.67-10.3). At both 30-day and 1-year follow-up, myocardial reperfusion therapies improved prognosis. CONCLUSIONS: Acute MI is associated with substantial mortality and morbidity in Côte d'Ivoire. These data can help local care providers identify those at highest risk and plan surveillance accordingly.