Department of Internal Medicine, School of Medicine & Dentistry, University of Dodoma, Dodoma, Tanzania.
Department of Cardiology, Benjamin Mkapa Hospital, Dodoma, Tanzania.
BMC Cardiovasc Disord. 2024 Feb 26;24(1):125. doi: 10.1186/s12872-024-03773-7.
Coronary artery disease (CAD) is an important cause of global burden of disease. There is a paucity of data on the burden and risk factors for CAD in sub-Saharan Africa (SSA), despite the rising trends in the shared risk factors across regions. The recent introduction of cardiac catheterization laboratory services in SSA could shed light on the burden of CAD in the region. We aimed to assess the angiographic characteristics among patients undergoing diagnostic coronary angiography (CAG) at a single tertiary care hospital in Tanzania.
This study was a retrospective chart review. A total of 728 patients ≥ 18 years of age who underwent CAG from January 2020 to December 2022 were recruited into the study. Basic demographic variables, risk factors and clinical characteristics including CAG findings were obtained from the registry. In addition, CAG images were retrieved for assessment of angiographic features. The luminal vessel stenosis was assessed based on eyeballing and the degree of obstruction was agreed by two independent and experienced cardiologists. The coronary stenosis of ≥ 50% was considered significant for obstructive CAD. The study was approved by the local ethics committee.
Of patients who were recruited into the study, 384 (52.23%) were female. The study participants had a mean age of 59.46 ± 10.83 standard deviation (SD) and mean body mass index (BMI) of 31.18 kg/m. The prevalence of CAD of any degree was estimated at 24.43% (34.18% in male, 15.50% in female), while that of obstructive CAD was 18.27%. Forty six percent of those with obstructive CAD had multiple vessel disease (MVD). Nearly 77% of patients were found to have ≥ 50-70% luminal stenosis and while those with ≥ 70% luminal coronary artery stenosis constituted 56.65%. Right coronary artery (RCA) was the most commonly affected vessel, accounting for 36.84% when any vessel disease or 56% when single vessel disease were considered. Being 65 years or older and comorbidity with type 2 diabetes (T2D) were independent risk factors for developing CAD.
There is a high prevalence of obstructive CAD among patients undergoing diagnostic CAG in Tanzania, with male gender preponderance and increasingly higher in older age, often with severe disease. A large, prospective study is needed to provide epidemiological and clinical data for developing a locally-relevant cardio-preventive strategy for CAD intervention in Tanzania.
冠心病（CAD）是全球疾病负担的重要原因。尽管各地区共享的危险因素呈上升趋势，但在撒哈拉以南非洲（SSA）地区，CAD 的负担和危险因素的数据仍然很少。最近在 SSA 地区引入了心脏导管实验室服务，可以了解该地区 CAD 的负担。我们旨在评估坦桑尼亚一家三级保健医院接受诊断性冠状动脉造影（CAG）的患者的血管造影特征。
本研究为回顾性图表审查。共招募了 728 名年龄≥18 岁的患者，他们在 2020 年 1 月至 2022 年 12 月期间接受了 CAG。从登记处获得了基本人口统计学变量、危险因素和临床特征，包括 CAG 结果。此外，还检索了 CAG 图像以评估血管造影特征。根据目测评估管腔血管狭窄程度，两位独立且经验丰富的心脏病专家同意阻塞程度。冠状动脉狭窄≥50%被认为是阻塞性 CAD 的重要标志。本研究得到了当地伦理委员会的批准。
在被纳入研究的患者中，384 名（52.23%）为女性。研究参与者的平均年龄为 59.46±10.83 标准差（SD），平均体重指数（BMI）为 31.18kg/m2。任何程度 CAD 的患病率估计为 24.43%（男性 34.18%，女性 15.50%），而阻塞性 CAD 的患病率为 18.27%。46%的阻塞性 CAD 患者有多血管疾病（MVD）。近 77%的患者发现有≥50-70%的管腔狭窄，而≥70%的管腔冠状动脉狭窄的患者构成 56.65%。右冠状动脉（RCA）是最常受累的血管，当考虑任何血管疾病时占 36.84%，当考虑单血管疾病时占 56%。65 岁或以上和合并 2 型糖尿病（T2D）是发生 CAD 的独立危险因素。
在坦桑尼亚接受诊断性 CAG 的患者中，阻塞性 CAD 的患病率很高，男性居多，年龄越大，疾病越严重。需要进行一项大型的前瞻性研究，为坦桑尼亚制定基于当地情况的 CAD 干预心血管预防策略提供流行病学和临床数据。
