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Associated Factors to Poor Blood Pressure Control in Hypertensives Followed Up at the Campus University Hospital of Lome (Togo)

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World Journal of Cardiovascular Diseases 2024年第6期14卷 374-380页

作者： Soulemane Pessinaba Yaovi Mignazonzon Afassinou Wiyao Dieudonné Kaziga Komlavi Yayehd Kolani Lamboni Sélim Bolarinwa Mohamed Kpélafia Ekpe Togbossi Akpe Adzodo Machihude Pio Soodougoua Baragou findibé damorou Cardiology Department University Hospital of Campus Lome Togo Cardiology Department Sylvanus Olympio University Hospital Lome Togo Cardiology Department Kara University Hospital Kara Togo

Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.

关键词： Hypertension Poor Control Associated factors Togo

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Contribution of Diagnosis Examinations in Pulmonary Embolism

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World Journal of Cardiovascular Diseases 2021年第12期11卷 564-571页

作者： Machihude Pio Doguessaga Borgiata Atta Yaovi Mignazonzon Afassinou Soulemane Pessinaba Hamza Doles Sama Tchaa Tchérou Ablavi Ena Todo-Alipui Wiyaou Dieudonnné Kaziga Abalo Mario Bakai Soodougoua Baragou findibé damorou Cardiology Department Kara Unviversity Hospital Kara Togo Cardiology Department Sokode Hospital Togo Cardiology Department Sylvanus Olympio University Hospital Lomé Togo Cardiology Department Campus University Hospital Lomé Togo

Background: We aimed to determine the specificities of pulmonary embolism (PE) investigations and their statistical link according to PE’s degrees of severity. Patients and Methods: It was a cross-sectional study on patient- records admitted in Cardiology Department for PE, from June 1st 2014 to April 30th 2019. We studied electrocardiogram (ECG), Chest X-ray, Echocardiographic, D-dimers, CT pulmonary angiographic (CTPA) data. PE diagnosis was retained at the CTPA. PE was classified according to its severity (low, intermediate, and severe). Patients were arbitrarily categorized in 4 groups (G1 - G4) according to D-dimer level. Results: We retained 110 patient- records of patients mean aged 56 ± 15 years, with female predominance (Sex-ratio F/M = 1.82). Patients with main pulmonary artery’s (MPA) embolism had D-dimer value > 5000 ng/mL. The more proximal embolism was located, the higher D-dimer level was, but no significant association was found between D-dimer level and PE’s severity. CTPA showed bilateral location of embolism in 52% of cases. Severe PE (SPE) was significantly associated to proximal location (main and segmental branches of PA), and repolarization disorders. S1Q3 aspect was associated to intermediate mortality risk PE. On chest X-r

关键词： Pulmonary Embolism D-Dimer Severity Diagnosis Togo

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Complicated High Blood Pressure in Hospital Area in Lomé

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Open Journal of Internal Medicine 2019年第2期9卷 5-11页

作者： Abago Balaka Kodjo Agbé ko Djagadou Toyi Tchamdja Mohaman Awalou Djibril findibe damorou Internal Medecine Unit Lom&#233 & Kara Togo Health Science Faculty Universit&#233 de Lomé Lom&#233 Togo Health Science Faculty Universit&#233 de Kara Kara Togo

The target of the study was to identify patients living with Compound high blood pressure and describe the epidemiological, treatment and progressive aspects. We had realized retrospective and descriptive study completed throughout twelve months from 1st January to December 31, 2011. The study took into account 250 hypertensives known or not admitted in the cardiology and medical intensive care units at the Sylvanus Olympio Teaching Hospital in Lomé. In total, the frequency of complications of the High Blood Pressure was 33.3% with a male predominance. Patients’ average age was 52.4 years. The most frequent reasons of admission were coma (32%) and hypertensive eruption (28%). The excessive consumption of salt and alcohol were other dominant modifiable risks factors with respectively 36.8% and 22.8%. Neurologic complications were the most frequent of cerebrovascular accidents (CVA) (66%) among which strokes represented 69.7%. Cardiac complications came in second position (31.2%). Double treatment was optional in 62.2% cases with IEC+ Ica++ associated. In 56.6% cases patients with renal disease in terminal stage had been dialysed. The level of total lethality was 34%. The main cause of death was CVA (cerebrovascular accidents) (85.9%). High Blood Pressure is then a very plague with regard to its complications. Its effective caretaking is nothing but through primary prevention based on sensitization, education of the entire grass-roots and it requires the mobilization of all social components.

关键词： High Blood Pressure Target Organs Complications Young Patient

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Hypertrophic Cardiomyopathies at the Sylvanus Olympio Teaching Hospital of Lome: Epidemiological, Diagnostic, Therapeutic and Evolutive Aspects

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World Journal of Cardiovascular Diseases 2022年第11期12卷 481-489页

作者： Baragou Soodougoua Afassinou Yaovi Mignazonzon Hourobia Watabisse Atta Borgatia Oloude Nansirine Pessinaba Souleymane damorou findibe University of Lome Lome Togo University of Kara Kara Togo

Background: Hypertrophic cardiomyopathy (HCM) is a form of cardiomyopathy that may involve several *** aim of our study is to describe the epidemiological, diagnostic, therapeutic and short-term prognostic aspects of this form of cardiomyopathy at the Sylvanus Olympio Teaching Hospital of Lome. Materials and Methods: This was a cross-sectional study that was carried out over a four-year period from January 1, 2016 to December 31, 2019. We included in this study, patients admitted to the Cardiology Department of the Sylvanus Olympio Teaching Hospital of Lome, in whom the diagnosis of hypertrophic cardiomyopathy was retained at echocardiography in the absence of any other cause that could explain the significant hypertrophy of the walls. Results: The prevalence of hypertrophic cardiomyopathies in our study was 0.31%. The mean age of patients was 51.35 ± 15.28 years with a male predominance (sex ratio M/F of 1.22). The majority of patients (60%) were between 45 and 74 years old. The clinical presentation was dominated by congestive heart failure in 15 patients (75%). Half of the patients (50%) had type III hypertrophic cardiomyopathy according to Maron’s classification. Seven patients (35%) had obstructive HCM and the mean thickness of the interventricular septum in diastole was 15.88. Left ventricular systolic function was impaired in 40% of patients. No patient was able to do a genetic test. The combination of beta-blocker (95%), an inhibitor of the renin- angiotensin-aldosterone system (90%) and furosemide (85%) constituted the essential part of the treatment combined with Lifestyle changes. No patients have benefited from implantable cardioverter defibrillators. The yearly mortality rate at the end of our study was 70%. Conclusion: Hypertrophic cardiomyopathy remains a relatively rare pathology. It is often a late diagnosis in the context of heart failure with limited therapeutic means, explaining its heavy morbidity and mortality.

关键词： Hypertrophic Cardiomyopathy Echocardiography Togo

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Effect of Antihypertensive Drug Therapy on the Blood Pressure Control among Hypertensive Patients Attending Campus’ Teaching Hospital of Lome, Togo, West Africa

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Pharmacology & Pharmacy 2012年第2期3卷 214-223页

作者： Yao Potchoo Edem Goe-Akue findibe damorou Barima Massoka Datouda Redah Innocent P. Guissou University of Lome Mixed Faculty of Medicine and Pharmacy Lome Togo University of Lome School of Medical Assistants Lome Togo University of Ouagadougou UFR/SOH Laboratory of Pharmacology/Toxicology Ouagadougou Burkina Faso

High blood pressure (HBP) is a health problem world—wide. In Togo, that affection constitutes a more and more pre-occupying cause of morbidity and mortality. This study is a prospective one which intended to identify the antihypertensive regimens prescribed and evaluate their effect on patients’ blood pressure (BP) control. Out of the 204 patients enrolled (mean: 55.01 ± 12.55 years;sex ratio: 1.3), 112/176 placed on antihypertensive therapy have controlled their BP (38.39% outpatients vs 61.61% inpatients). Related to the sex factor, we didn’t observe any significant difference in the BP control. Whereas, the mean median value of BP reduction of outpatients (30.00/15.00 mmHg) (p = 0.001) was half lower than that of inpatients (60.00/30.00 mmHg (p = 0.004)). Thirty five outpatients (81.40%) vs 64 inpatients (92.75%) were placed on combination therapy. The bitherapy was prescribed to 23 outpatients (53.49%) against 27 inpatients (39.13%) while the quadritherapy and more than 4 drugs combination were prescribed exclusively to inpatients (20.29%, n = 14). That quadritherapy induced a significant mean reduction of inpatients’ SBP compared to monotherapy (p = 0.043) and to bitherapy (p = 0.004). The favorite combinations were D + CCA, D + ACEI, D + CCA + ACEI and D + CCA + ACEI + CAAD of which the quadruple therapy showed a significant inpatients’ DBP control (p = 0.015) compared to D + CCA combination. The combinations including at least one diuretic induced a significant difference between outpatients (median value: 30.000/10.000 mmHg) (p < 0.001) and inpatients (median value: 60.000 mmHg/30 mmHg) (p < 0.001). The first-line molecules and fixe combinations prescribed in decreasing frequency were among others: hydrochlorothiazide + captopril, nicardipine, α methyldopa for outpatients;furosemide, nicardipine, captopril, α methyldopa, hydrochlorothiazide + captopril for inpatients. Diuretics, CCAs and ACEIs were the 3 favorite pharmacological groups for essential hyperten

关键词： Antihypertensive Drugs Ambulatory Patients Hospitalized Patients Blood Pressure Control Prescription Monotherapy Bitherapy Tritherapy Quadritherapy CHU-Campus Togo West Africa

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Mortality in Cardiology in Sub-Saharan Africa: Case of the Cardiology Department of the Teaching Hospital Sylvanus Olympio of Lome

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World Journal of Cardiovascular Diseases 2023年第8期13卷 477-492页

作者： Afassinou Yaovi Mignazonzon Dola Kossi Edem Pessinaba Soulemane Atta Borgatia Pio Machihude Baragou Soodougoua damorou findibe Cardiology Department Sylvanus Olympio Teaching Hospital of Lome Lome Togo Cardiology Department Teaching Hospital Campus of Lome Lome Togo Medical Department Sokode Regional Hospital Center Sokode Togo Cardiology Department Kara Teaching Hospital Kara Togo

Background: Cardiovascular disease is the leading cause of death worldwide. The specificities of cardiology mortality in Togo are not well known. The objective of this study was to determine the profile of deaths in the cardiology department of the Sylvanus Olympio Teaching Hospital (CHU SO) in Lome. Materials and Methods: This was a cross-sectional study conducted over a period of 06 years, from January 1, 2015 to December 31, 2021, in the cardiology department of the Sylvanus Olympio Teaching Hospital in Lome. In this study, we included all medical records of patients who died in hospital in the cardiology department during the study period. Results: During the study period, 2762 patients were hospitalized in the cardiology unit at CHU SO. We recorded 112 deaths meeting our criteria, for an intrahospital mortality rate of 4.19%. The average age of patients was 53.79 ± 18.27 years. Hypertension was present in 47.3%. Sickness insurance coverage was not available for 94.64% of those who died. The major cardiovascular diseases observed were myocardium in 43.75% whose dilated cardiomyopathy accounted for 71.42%;and rhythmic lesions in 34.82%. Biological infectious syndrome (56.25%), renal failure (48.21%), anemia (47.27%), lung infection (32.14%), hyponatremia (33.04%) were the main comorbidities observed. Among the circumstances of death, sudden death was found in 32.14%, cardiogenic shock in 20.54% and septic shock in 13.39%. Conclusion: The profile of deaths in the cardiology department of the CHU SO reveals that myocardial injuries are more present with circumstances of death dominated by sudden death.

关键词： Mortality Rate Cardiology CHU Sylvanus Olympio

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Economic and Psychosocial Impacts of Health Evacuations Abroad for Coronary Angioplasty in Togolese Patients

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World Journal of Cardiovascular Diseases 2021年第12期11卷 583-592页

作者： Mouhaman-Inouwa Kpelafia Soulemane Pessinaba Abdou Razak Moukaila Marodégueba Barma Nkenon Watani N’Da Yawo Dodzi Molba Atti Ekpé Togbossi Komlavi Yayehd findibe damorou Department of Cardiology CHU Campus University of Lomé Lomé Togo Department of Internal Medicine University of Lomé Lomé Togo

Introduction: Coronary artery disease is the leading cause of premature death worldwide. The management of its severe form requires angioplasty, not yet available a year ago in Togo, which motivated the evacuation of Togolese patients with this disease. Objectives: To evaluate the cost of angioplasty and the economic and psychosocial impacts in evacuated Togolese patients. Methodology: This was a three-year descriptive and prospective study (January 2015 to December 2018) that included all Togolese patients evacuated for coronary angiography from 4 health facilities in the city of Lomé. Results: The mean age was 56.8 ± 11 years. There was a male predominance with a sex ratio of 2.63. The main countries of evacuation were France (50%), Tunisia (25%) and Ivory Coast (20%). The main indications of coronary angiography were myocardial infarction in 47.5%, NSTEMI (22.5%) and ischemic heart disease (15%). Fifty-five percent of the patients had monotroncular involvement. Angioplasty was performed in 16 patients, 3 patients had bypass surgery and only one patient had medical treatment. Sixty percent of patients received an active stent and 20% a bare stent. The total cost of the 40 evacuations was four hundred and fifty one thousand four hundred and nineteen US dollars (US$451,419). The average cost per evacuation was eleven thousand two hundred and eighty-six US dollars (US$11,286), or 182 times the Togolese minimum wage. At the announcement of the disease and evacuation, 40% had been afraid and 35% had accepted their illness. Fifty-five percent perceived evacuation as a healthy outcome. In 25% of cases the coronary angiography was simple and 20% found it painful. After the coronary angiography 40% had regained hope of recovery, 37.5% had accepted their result and 37.5

关键词： Evacuation Cost Angioplasty Economic Impact ACS

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Assessment of Oral Anticoagulation with Vitamin K Antagonists in Patients Living in a Low-Income Country of West Africa

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World Journal of Cardiovascular Diseases 2024年第1期14卷 27-42页

作者： Komlavi Yayehd Tchaa Tcherou Hervé Libérus A. Edorh Agossou Defodji Mohamed Kpelafia Ekpé Togbossi Ablawa Adzodo Soulemane Pessinaba Machihude Pio Soodogoua Baragou findibe damorou Department of Cardiology Faculty of Health Sciences University of Lomé Lomé Togo Department of Cardiology Faculty of Health Sciences University of Kara Kara Togo

Introduction: Despite the rise of direct oral anticoagulants (DOACs), vitamin K antagonists (VKA) remain the most widely used oral anticoagulants in developing countries. The aim of this study was to estimate the prevalence of good anticoagulation in patients treated with VKA in Lomé and describe associated factors. Methods: This was a cross-sectional study conducted from November 2019 to October 2020 in the cardiology departments of two University teaching hospitals in Lomé (CHU Sylvanus Olympio and CHU Campus), involving patients on VKA for ≥3 months, with a target international normalized ratio (INR) of 2.5 and a therapeutic margin between 2 and 3. The quality of anticoagulation was assessed by the time in therapeutic range (TTR) which was assessed by the Rosendaal method. Good anticoagulation was defined by a TTR > 70%. Results: A total of 344 patients were included (mean age = 58 ± 13.8 years, women = 56.1%). Indications for VKA treatment were represented by venous thromboembolic disease (43.3%), supraventricular arrhythmia (28.2%), severe left ventricular systolic dysfunction (19.8%) and pulmonary hypertension (8.7%). The average TTR was 47.6 ± 20.8%. The rate of good anticoagulation was 17.7%. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol (OR = 11.17;95% CI: 3.2 - 39.6;p = 0.0002), concomitant low-dose aspirin (OR 4.44;95% CI: 1.4 - 13.9;p = 0.01) and INR monitoring exclusively by the patient himself (OR = 4.92;95% CI: 1.5 - 16.3;p = 0.008). The rate of thromboembolic and hemorrhagic complications was each 2.6% and was not correlated with the quality of anticoagulation. Quality of anticoagulation by VKAs was poor in our practice. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol, concomitant low-dose aspirin and monitoring of INR exclusively by the patient himself. Conclusion: The quality of oral anticoagulation by VKAs could be improved in our practice by the creation of antico

关键词： Vitamin K Antagonists Time in Therapeutic Range Lomé Togo

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Ventricular Non-Compaction: About the First Cases Reported in Lomé(Togo)

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World Journal of Cardiovascular Diseases 2020年第12期10卷 775-783页

作者： Soodougoua Baragou Soulemane Pessinaba Tchalla Abéna Ekpé Togbossi Wiyaou Kaziga Komlavi Yayehd Mohamed Kpélafia Nkenon Watani N’Da El Nassirine Oloudé Machihude Pio findibe damorou Cardiology Department Sylvanus Olympio Teaching Hospital Lomé Togo Cardiology Department Campus Teaching Hospital Lomé Togo Cardiology Department Tomde Hospital Kara Togo Cardiology Department Kara Teaching Hospital Kara Togo

Introduction: Ventricular non-compaction, a cardiomyopathy recently described as likely to be rare, belongs to the group of unclassified cardiomyopathy according to European Society of Cardiology. Few studies have been published on the ventricular non-compaction in sub-Saharan Africa. We aim to find out the various aspects, being diagnosis, therapeutic, in Togolese patients carrying the ventricular non-compaction. Methodology: This is a three-year prospective and descriptive study conducted from January 2017 to December 2019 in the two University Hospital of Lomé. Patients having echocardiographic criteria of ventricular non-compaction were included in our study. Results: 10 patients (6 men and 4 women) were diagnosed for ventricular non-compaction during the study period. The mean age of patients was 32.3 years. The most frequent clinical manifestation was heart failure (7 patients). The main electrocardiogram anomaly was left ventricle hypertrophy (9 patients). The preferential segments were: apical (9 cases), apicolateral (8 cases), and septoapical (7 cases). The average ratio of non-compaction/compaction was 3.31. The main complication was thromboembolic event (4 patients). Angiotensin converting enzyme inhibitors and beta-blockers were essentially the medicines used. After a three (3) year follow-up, two (2) of the patients died. Conclusion: Tough ventricular non-compaction has been recently described. It is present in Togo. It displays many clinical manifestations and the prognosis is often guarded.

关键词： Ventricular Non-Compaction Hypertrophy Sub-Saharan Africa Heart Failure Togo

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Brugada Syndrome Type 1 Electrocardiogram Pattern Induced by Fever in a Black African: A Case Report

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World Journal of Cardiovascular Diseases 2020年第8期10卷 558-562页

作者： Soulemane Pessinaba Ekpé Togbossi Wiyaou Kaziga Baete Koudéma Pizeriwé Dossim Komlavi Yayehd Mohamed Kpélafia Nkenon Watani N’Da Borgatia Atta Tchaa Tchérou Yaovi Afassinou Machihude Pio Soodougoua Baragou Adama Kane findibe damorou Cardiology Department Campus Teaching Hospital Lome Togo Cardiology Department Kara Teaching Hospital Kara Togo Cardiology Department Sylvanus Olympio Teaching Hospital Lome Togo Cardiology Department Saint-Louis Hospital Saint-Louis Senegal

Brugada syndrome is a channelopathy that can be familial or sporadic. It is a major cause of sudden death in young people with no obvious heart structural abnormality. The electrocardiogram can be dynamic over time with sometimes normalization. Several pathophysiological conditions are known to induce the electrocardiographic expression of the syndrome. We report here the case of a 65-year-old hypertensive man, without syncope or family sudden death history who was hospitalized for shigella gastroenteritis. Electrocardiogram during fever showed an incomplete block and ST segment elevation with negative T waves in V1 and V2 suggested type 1 Brugada syndrome. Troponin was negative. Electrocardiogram after fever recovered an incomplete right block and normalization of the ST segment. Electrocardiogram should be performed in patients admitted to the emergency unit for infectious syndrome in our countries. This may reveal a number of patients with Brugada syndrome abnormalities.

关键词： Brugada Syndrome Electrocardiogram Fever

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