TY - JOUR
T1 - Thirty-day outcomes and predictors of mortality following acute myocardial infarction in northern Tanzania
T2 - A prospective observational cohort study
AU - Goli, Sumana
AU - Sakita, Francis M.
AU - Kweka, Godfrey L.
AU - Tarimo, Tumsifu G.
AU - Temu, Gloria
AU - Thielman, Nathan M.
AU - Bettger, Janet P.
AU - Bloomfield, Gerald S.
AU - Limkakeng, Alexander T.
AU - Hertz, Julian T.
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Objective: There is a rising burden of myocardial infarction (MI) within sub-Saharan Africa. Prospective studies of detailed MI outcomes in the region are lacking. Methods: Adult patients with confirmed MI from a prospective surveillance study in northern Tanzania were enrolled in a longitudinal cohort study after baseline health history, medication use, and sociodemographic data were obtained. Thirty days following hospital presentation, symptom status, rehospitalizations, medication use, and mortality were assessed via telephone or in-person interviews using a standardized follow-up questionnaire. Multivariate logistic regression was performed to identify baseline predictors of thirty-day mortality. Results: Thirty-day follow-up was achieved for 150 (98.7%) of 152 enrolled participants. Of these, 85 (56.7%) survived to thirty-day follow-up. Of the surviving participants, 71 (83.5%) reported persistent anginal symptoms, four (4.7%) reported taking aspirin regularly, seven (8.2%) were able to identify MI as the reason for their hospitalization, and 17 (20.0%) had unscheduled rehospitalizations. Self-reported history of diabetes at baseline (OR 0.32, 95% CI 0.10–0.89, p = 0.04), self-reported history of hypertension at baseline (OR 0.34, 95% CI 0.15–0.74, p = 0.01), and antiplatelet use at initial presentation (OR 0.19, 95% CI 0.04–0.65, p = 0.02) were all associated with lower odds of thirty-day mortality. Conclusions: In northern Tanzania, thirty-day outcomes following acute MI are poor, and mortality is associated with self-awareness of comorbidities and medication usage. Further investigation is needed to develop interventions to improve care and outcomes of MI in Tanzania.
AB - Objective: There is a rising burden of myocardial infarction (MI) within sub-Saharan Africa. Prospective studies of detailed MI outcomes in the region are lacking. Methods: Adult patients with confirmed MI from a prospective surveillance study in northern Tanzania were enrolled in a longitudinal cohort study after baseline health history, medication use, and sociodemographic data were obtained. Thirty days following hospital presentation, symptom status, rehospitalizations, medication use, and mortality were assessed via telephone or in-person interviews using a standardized follow-up questionnaire. Multivariate logistic regression was performed to identify baseline predictors of thirty-day mortality. Results: Thirty-day follow-up was achieved for 150 (98.7%) of 152 enrolled participants. Of these, 85 (56.7%) survived to thirty-day follow-up. Of the surviving participants, 71 (83.5%) reported persistent anginal symptoms, four (4.7%) reported taking aspirin regularly, seven (8.2%) were able to identify MI as the reason for their hospitalization, and 17 (20.0%) had unscheduled rehospitalizations. Self-reported history of diabetes at baseline (OR 0.32, 95% CI 0.10–0.89, p = 0.04), self-reported history of hypertension at baseline (OR 0.34, 95% CI 0.15–0.74, p = 0.01), and antiplatelet use at initial presentation (OR 0.19, 95% CI 0.04–0.65, p = 0.02) were all associated with lower odds of thirty-day mortality. Conclusions: In northern Tanzania, thirty-day outcomes following acute MI are poor, and mortality is associated with self-awareness of comorbidities and medication usage. Further investigation is needed to develop interventions to improve care and outcomes of MI in Tanzania.
KW - Acute myocardial infarction
KW - Emergency medicine
KW - Outcomes
KW - Sub-Saharan Africa
KW - Tanzania
UR - http://www.scopus.com/inward/record.url?scp=85112583686&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2021.08.002
DO - 10.1016/j.ijcard.2021.08.002
M3 - Article
C2 - 34364908
AN - SCOPUS:85112583686
SN - 0167-5273
VL - 342
SP - 23
EP - 28
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -