Epidemiology of Cardiovascular Mortality in Patients under 60 Years Old in a Cardiology Department in West Africa, Dakar-Senegal

Background: Our study aimed to examine cardiovascular mortality within the working-age population, exploring epidemiological, clinical, and paraclinical features, complications, and identifying etiological factors linked to mortality. Methods: We conducted a descriptive and analytical retrospective study from September 2019 to August 2022 at the General Hospital Idrissa POUYE in Dakar, we reviewed all the medical records of patients from 15 to 60 years old who died while admitted in the cardiology department. Data collected were socioeconomic status, clinical history, type of cardiovascular disaese, length of hospitalization, circumstances and timing of death. The data were analyzed with R. Studio version 2022.12.0 + 353 and Excel 2019, with a P-value < 0.05 considered as statistically significant. Results: The study included 73 patients, indicating a specific mortality rate of 8.8% and a proportional mortality of 39%. Predominantly male (sex ratio 1.2), the average age was 44. Key cardiovascular risk factors identified were sedentarism (76.7%), hypertension (28.8%), and smoking (21.9%). The leading cause for consultation was dyspnea (72.6%). Notable findings included a majority of patients presenting with general condition deterioration (90%) and cardiovascular collapse upon admission (23.3%). Physical exam revealed signs of heart failure in 63%. Echocardiography showed left ventricular ejection fraction impairment (81%) and pulmonary hypertension (78%). Immediate causes of death were primarily cardiogenic shock (45.2%) and septic shock (37%). The analytical study indicates that the data most closely associated with mortality were age, socio-economic level, ischemic heart disease (p = 0.034), rheumatic valvulopathies, pulmonary embolism (p = 0.034), hypertension (HTA) (p = 0.009), smoking (p = 0.011), diabetes (p = 0.011), dyslipidemias, prolonged bedrest (p = 0.001), morbid obesity (p = 0.001), and COVID-19 infection (p = 0.017). Conclusion: The prevalence of ischemic heart diseases, pulmonary embolisms, and valvulopathies in premature mortality statistics underscores the need for enhanced cardiovascular prevention efforts.