Cardiovascular Journal of Africa最新文献

{"title":"Urinary dopamine, sodium handling, and blood pressure in a bi-ethnic South African population: the SABPA study.","authors":"Moliehi M Mothae, Ruan Kruger, Lebo F Gafane-Matemane","doi":"10.5830/CVJA-2025-053","DOIUrl":"10.5830/CVJA-2025-053","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary dopamine is associated with increased sodium excretion in experimental studies, and possibly contributes to blood pressure (BP) regulation and salts-ensitivity. Studies in humans are limited, and the potential association with potassium is unclear. We aimed to compare urinary dopamine/creatinine ratio and investigate the associations of urinary dopamine/creatinine ratio with BP, sodium, potassium, and sodium/potassium ratio (Na/K) in Black and White adults.</p><p><strong>Methods: </strong>We included Black (n = 160) and White (n = 197) men and women aged 20-65 years. We recorded 24-hour BP, measured urinary dopamine and creatinine, and calculated their ratio. Urinary sodium and potassium were measured, and Na/K ratio calculated.</p><p><strong>Results: </strong>Urinary dopamine/creatinine ratio was lower in the Black group (p = 0.030) as compared to the White group, while urinary dopamine metabolites were higher in the Black group (p ≤ 0.001) compared to the White group. In multiple regression analyses, the following significant associations were confirmed: urinary dopamine/creatinine ratio associated positively with sodium and potassium in both the Black and White groups (all ß ≥ 0.296; p < 0.001) and negatively with Na/K ratio (ß = -0.285; p < 0.001) only in the Black group. No associations were observed between urinary dopamine/creatinine ratio and BP.</p><p><strong>Conclusion: </strong>The lower levels of urinary dopamine in the Black group as compared to their White counterparts could be explained by the higher urinary dopamine metabolite levels in the Black group, due to a possible higher rate in the metabolism of urinary dopamine and low potassium levels observed in this group. The unique negative association between urinary dopamine and Na/K_{-_}ratio only in the Black participants suggest that potassium may contribute significantly to the renal sodium-handling properties of renal dopamine in Black populations.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"403-411"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of resting heart rate on coronary collateral formation in patients with chronic total occlusion: resting heart rate and collaterals.","authors":"Samet Yilmaz, Anıl Türköz, M Koray Adali, Dursun Dursunoğlu","doi":"10.5830/CVJA-2025-084","DOIUrl":"10.5830/CVJA-2025-084","url":null,"abstract":"<p><strong>Aim: </strong>In this study our aim was to determine the effect of resting heart rate (HR) on the development of coronary collateral circulation (CCC) in patients with chronic total occlusion (CTO).</p><p><strong>Methods: </strong>A total of 219 patients who had CTO on their coronary angiography were divided into two groups according to their collateral status. CCC was graded by Rentrop Classification.</p><p><strong>Results: </strong>Patients with poor collaterals had significantly higher resting HR (79±13.9 vs 74.3±10.5, p=0.005) compared to patients with well collaterals. According to backward logistic regression analyses low HR (OR:0.974, p=0.033), high ejection fraction (OR:1.026, p=0.043) and the presence of CTO at the right coronary artery (OR7colon;3.201, p<0.001) were found to be significantly related with coronary collateral development.</p><p><strong>Conclusions: </strong>Increased heart rate was found to be a risk factor for poor collateral formation.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"619-624"},"PeriodicalIF":0.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between the electromechanical window and ventricular arrhythmia prevalence in HFrEF patients with ICD.","authors":"Aslı Nalbant, Pelin Karaca Özer, Mustafa Lütfi Yavuz, Zeynep Gizem Demirtakan, Ali Elitok, Ahmet Kaya Bilge, Aytaç Öncül","doi":"10.5830/CVJA-2025-081","DOIUrl":"10.5830/CVJA-2025-081","url":null,"abstract":"<p><strong>Aim: </strong>The electromechanical window (EMW) refers to the time interval between aortic valve closure and the end of the T-wave during the same cardiac cycle. Recent studies highlight the role of EMW in assessing the risk of ventricular arrhythmia. This study examines the predictive value of the EMW for ventricular arrhythmias in heart failure with reduced ejection fraction (HFrEF) patients with an implantable cardioverter defibrillator (ICD).</p><p><strong>Materials and methods: </strong>This single-centre study included 52 HFrEF patients with ICD. The patients were divided into two groups based on the presence or absence of anti-tachycardia pacing (ATP) or shock therapy during ICD interrogation: those without therapy (n = 28) and those with therapy (n = 24). EMW duration was measured by echocardiography. The groups were compared with sex and age-matched controls (n = 24).</p><p><strong>Results: </strong>The groups were homogeneous in terms of age and sex. EMW was lower in the ICD therapy group compared to without therapy and control groups (-25.17 ± 31.5 vs. 0.61 ± 25.1 vs. 9.21 ± 21.1; respectively, p < 0.001), while ECG-QTc duration did not differ between groups (p = 0.053). An EMW value below -22.5 ms demonstrated 69% sensitivity and 79% specificity in predicting ventricular fibrillation (AUC: 0.766, 95% CI 0.598-0.935), 57% sensitivity and 83% specificity in predicting ATP/shock therapy (AUC: 0.722, 95% CI 0.577-0.866), 67% sensitivity and 82% specificity in predicting shock therapy (AUC: 0.770, 95% CI 0.620-0.921).</p><p><strong>Conclusion: </strong>EMW is an up-to-date parameter easily measured with echocardiography. Our study shows that negative extension of EMW is a valuable predictor of ventricular arrhythmias and ICD therapies.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"608-614"},"PeriodicalIF":0.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension treatment practices and outcomes at health community centres in urban Soweto, South Africa.","authors":"Kudakwashe Nyamupangedengu, David Twesigomwe, Andrew K May, Neil Martinson, Ziyaad Waja, Raadhiya Osman, Collen Masimirembwa, Michèle Ramsay","doi":"10.5830/CVJA-2025-060","DOIUrl":"10.5830/CVJA-2025-060","url":null,"abstract":"<p><p>In this study, we explored hypertension (HT) management in urban Soweto, South Africa, involving 364 participants from primary healthcare clinics. At baseline, 40% of participants were prescribed one drug, and 53% were given two drugs. Thiazide diuretics and calcium channel blockers were most prescribed at baseline. Blood pressure (BP) control at the first follow-up was achieved by 50% of those on single-drug therapy and 52% of those on two-drug therapy. Men showed higher rates of uncontrolled BP (60%) compared to women (42%). Significant factors influencing BP reduction included age, sex, waist circumference, and treatment clinic. In this study, single and combination therapies yielded similar outcomes in BP control. The study suggests that HT treatment approaches varied between clinics, potentially due to comorbidities and continuity of care challenges. Further research is needed to identify best practices across different South African settings, considering drug availability and cost.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"438-448"},"PeriodicalIF":0.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do preoperative low triiodothyronine levels affect early kidney injury after coronary artery bypass grafting? A retrospective study.","authors":"Sedat Ozcan, Gündüz Yümün","doi":"10.5830/CVJA-2025-087","DOIUrl":"10.5830/CVJA-2025-087","url":null,"abstract":"<p><strong>Objective: </strong>Acute kidney injury is a common complication of cardiac surgery, and factors such as advanced age, diabetes mellitus, and low left ventricular function are reported to be risk factors for the development of acute kidney injury after coronary artery bypass grafting (CABG). There are few studies in the literature reporting the relationship between preoperative low T3 syndrome and cardiac surgery-related acute kidney injury. In this study, ı aimed to evaluate the effect of preoperative free T3 levels on early postoperative kidney injury based on glomerular filtration rate and acute kidney injury development in isolated elective on-pump coronary artery bypass grafting patients.</p><p><strong>Methods: </strong>The study was conducted in our hospital on patients who underwent isolated elective on-pump CABG surgery. Patients who underwent other open-heart surgery other than CABG, patients who had previously undergone open-heart surgery, patients who underwent off-pump CABG, patients with known preoperative renal failure, patients with known thyroid disease, and patients for whom the study data were not available were excluded. Finally, a total of 183 patients included in this study were examined and compared in two groups according to their preoperative fT3 levels.</p><p><strong>Results: </strong>The mean preoperative fT3 value was 2.06 ± 0.74 in Group 1 and 2.93 ± 0.53 in Group 2 (p = 0,000). The preoperative glomerular filtration rate value was 86.36 ± 11.16 and 88.78 ± 15.79 in Group 1 and Group 2, respectively (p = 0.150). Preoperative Hgb, diabetes mellitus, and age data were similar in both groups (p = 0.487, p = 0.936, and p = 0.073, respectively). The mean glomerular filtration rate change ratio (postoperative/preoperative glomerular filtration rate) was 0.93 ± 0.13 and 1.05 ± 0.56 (p = 0.437) for Groups 1 and 2, respectively.</p><p><strong>Conclusion: </strong>As a conclusion, according to the results of this study, no association was found between preoperative low fT3 and the development of postoperative acute kidney injury in on-pump coronary artery bypass grafting patients. However, we believe that further prospective studies with larger patient numbers would be beneficial to investigate the relationship between specific thyroid hormone disorders and the development of acute kidney injury after coronary artery bypass grafting.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"641-645"},"PeriodicalIF":0.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effects of dapagliflozin on subclinical atherosclerosis with two non-invasive methods: pulse wave velocity and carotid intima-media thickness.","authors":"Muhammet Kocabaş, İsmail Baloğlu, Mustafa Can, Ömer Faruk Demir, Melia Karaköse, Kültigin Türkmen","doi":"10.5830/CVJA-2025-086","DOIUrl":"10.5830/CVJA-2025-086","url":null,"abstract":"<p><strong>Objective: </strong>Recent cardiovascular outcome trials have shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors reduce cardiovascular events, but results regarding their effects on subclinical atherosclerosis are conflicting. In this study, we aimed to investigate the effect of dapagliflozin, a selective SGLT2 inhibitor, on subclinical atherosclerosis by monitoring pulse wave velocity (PWV) and carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Materials and methods: </strong>Forty-eight patients with T2DM and on dapagliflozin treatment were included in the study. Demographic variables, anthropometric indices and laboratory parameters were obtained from the patient files. Baseline and 6th-month PWV and cIMT values were obtained. The percentage changes from baseline in all continuous variables with six months of dapagliflozin were calculated.</p><p><strong>Results: </strong>Compared to baseline values, we found that cIMT decreased from 0.70 (0.50-1.10) mm to 0.60 (0.40-1.00) mm and PWV decreased from 9.52 ± 1.59 m/s to 9.16 ± 1.55 m/s in the 6th month of treatment (p < 0.001 and p < 0.001, respectively). The percentage decrease in cIMT (ΔcIMT) was 14.65 ± 11.88% and in PWV (ΔPWV) was 3.76 ± 4.08%. ΔcIMT was positively correlated with baseline cIMT, BMI and fat mass values (p = 0.019, p = 0.023 and p = 0.030, respectively). 1PWV was positively correlated with baseline systolic blood pressure (p = 0.020).</p><p><strong>Conclusions: </strong>According to the results of our study, dapagliflozin treatment reduces PWV and cIMT, and the decrease in these markers was greater among patients with higher baseline SBP, cIMT, BMI and fat mass. These results suggest that, if supported by more comprehensive studies, the cardiovascular benefits of dapagliflozin may be greater in patients with higher baseline cardiovascular risk.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"634-640"},"PeriodicalIF":0.7,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of metoprolol and bisoprolol on bleeding rates in patients with atrial fibrillation.","authors":"Sefa Erdi Ömür, Gülşen Genç Tapar, Çağrı Zorlu, Kayıhan Karaman, Yağmur Demirezen","doi":"10.5830/CVJA-2025-075","DOIUrl":"10.5830/CVJA-2025-075","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a complex disease with irregular ventricular response and tachycardia as a result of irregular and rapid contraction of the atria, with poor cardiovascular outcomes unless treated. Beta-blockers are commonly used agents in the treatment of AF. The effects of beta-blockers on bleeding continue to be evaluated.</p><p><strong>Aim: </strong>Bleeding is a common complication in AF. In current cases, the evaluation of bleeding contributes to the follow-up of the disease. Our study aims to evaluate the effect of beta-blockers on bleeding in patients with AF.</p><p><strong>Method: </strong>The study was conducted retrospectively, and a total of 4004 patients hospitalised in a cardiology outpatient clinic were included. The patients were divided into two groups: those using metoprolol (n = 2481) and those using bisoprolol (n = 1523). Bleeding rates were evaluated.</p><p><strong>Results: </strong>Bleeding events in the entire group were as follows; gastrointestinal bleeding in 164 patients (35.65%), epistaxis in 109 patients (23.69%), eye bleeding in 47 patients (10.21%), genitourinary bleeding in 39 patients (58.47%), oral bleeding in 35 patients (7.60%), subcutaneous bleeding in 28 patients (6.08%), intracranial bleeding in 19 patients (4.13%), traumatic bleeding in 16 patients (3.47%), and haemoptysis in 3 patients (0.65%). Both Bleeding Academic Research Consortium (BARC) type ≥ 2 and BARC ≥ 3 bleeding events were significantly higher in the bisoprolol group (p < 0.001).</p><p><strong>Conclusion: </strong>According to this study, the risk of bleeding in AF patients using metoprolol was found to be lower than in patients using bisoprolol. Accordingly, using metoprolol in AF patients seems safer.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"538-544"},"PeriodicalIF":0.7,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MiR-126 prevents hypoxic HUVEC cellular injury through targeting TRAF6 expression.","authors":"Md Sayed Ali Sheikh","doi":"10.5830/CVJA-2025-019","DOIUrl":"10.5830/CVJA-2025-019","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to determine the clinical impact of miR-126 in identifying the severity of atherosclerotic CAD patients and its protective molecular mechanism against hypoxic exposed human umbilical vein endothelial cells (HUVEC) injury.</p><p><strong>Methods: </strong>124 multivessel blocked CAD patients, 87 double vessels stenosed CAD subjects, single vessel occluded 50 CAD patients, age and gender-matched 50 healthy individuals, and hypoxic-induced human umbilical vein endothelial cells were enrolled in this study. Quantitative real-time PCR (qRT-PCR) was used for the detection of relative miRNAs and mRNAs expressions and the severity of CAD patients was determined by the ROC analysis.</p><p><strong>Results: </strong>Circulating plasma miR-126 expressions were greatly reduced in multivessel CAD patients as compared with the single and dual vessel as well as healthy subjects. Significantly expressed plasma miR-126 was also observed within single and multivessel CAD patients. Multivessel, double vessel, and single vessel atherosclerotic blocked CAD patients were highly distinguished from healthy volunteer participants with remarkable specificity and sensitivity and exhibited a prominent AUC of 0.940, 0.937, and 0.908 respectively. The relative expressions of miR-126 were comparatively lower in hypoxic induced HUVEC than in normal atmospheric cultured cells. Moreover, the expressions of LDH, caspase- 3 activities, ROS, and TRAF6 have significantly upregulated in hypoxic exposed HUVEC. In contrast, overexpression of miR-126 evidently reduced ROS production, LDH secretion, caspase-3 activities, and TRAF6 protein levels, and markedly elevated HUVEC cellular viability under hypoxic stress conditions.</p><p><strong>Conclusions: </strong>Down-regulated plasma miR-126 acts as a newer universal clinical biomarker for the early detection and grading of CAD patients. Mimic expression of miR-126 significantly enhanced HUVEC cellular viability via targeting TRAF6 protein expression under hypoxic-induced inflammatory conditions, suggesting a newer molecular target for atherosclerotic CAD patients.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"430-438"},"PeriodicalIF":0.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid AI-assisted Poincaré plot analysis for early detection of subclinical left ventricular dysfunction in hypertensive patients admitted to the emergency department: A prospective observational study.","authors":"Erhan Arıkan, Faik Özel, Ramazan Aslan, Murat Özmen, Ahmet Ardahanlı, İsa Ardahanlı","doi":"10.5830/CVJA-2025-069","DOIUrl":"10.5830/CVJA-2025-069","url":null,"abstract":"<p><strong>Introduction: </strong>Early detection of subclinical left ventricular (LV) dysfunction in hypertensive patients presenting to the emergency department (ED) is of critical importance. We aimed to evaluate the performance of artificial intelligence (AI)-assisted Poincaré plot analysis of electrocardiogram (ECGs) to identify subclinical LV dysfunction rapidly.</p><p><strong>Methods: </strong>60 hypertensive patients and 55 normotensive controls were prospectively enrolled in the ED. After stabilisation, all participants underwent 5-minute ECG recordings. Heart rate variability (HRV) measurements were calculated, and Poincaré plots were generated. A convolutional neural network (CNN) model was trained to classify the Poincaré plot images. Transthoracic echocardiography was performed within 24 hours to measure left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). Subclinical dysfunction was defined as GLS > -18% with preserved LVEF.</p><p><strong>Results: </strong>The CNN model detected subclinical LV dysfunction by achieving an area under the curve (AUC) of 0.91 (95% CI: 0.84-0.96). Conventional HRV measurements showed a moderate correlation with GLS (r = 0.48), while AI-based Poincaré plot analysis had a stronger correlation (r = 0.70). The time from ECG acquisition to automatic analysis was less than 5 minutes.</p><p><strong>Conclusions: </strong>AI-assisted Poincaré plot analysis enables rapid and non-invasive detection of subclinical LV dysfunction in hypertensive patients in the ED, supporting early risk stratification.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"491-498"},"PeriodicalIF":0.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective description of acute coronary syndromes presenting to prehospital providers in the Western Cape, South Africa.","authors":"Lynch Andrew, Stassen Willem","doi":"10.5830/CVJA-2025-078","DOIUrl":"10.5830/CVJA-2025-078","url":null,"abstract":"<p><strong>Introduction: </strong>The growing prevalence of cardiovascular disease (CVD) in Africa remains a significant public health and socioeconomic issue. Disease manifestations include acute coronary syndrome (ACS) and, crucially, ST-segment myocardial infarction (STEMI), predominantly resulting in serious or long-term complications often overburdening healthcare systems. Comprehensive treatment strategies emphasising timely reperfusion of infarct-related arteries remain a crucial step in the management of acute coronary care. To achieve this, incidents of ACS - and specifically STEMI - need to be described, especially considering settings where time to reperfusion might have been delayed significantly. The aim was to identify and detail incidents of ACS in the prehospital setting, specifically in the Western Cape, South Africa.</p><p><strong>Methods: </strong>The study comprised a retrospective chart review of prehospital electronic patient care reports over a 12-month period (1 January 2018 to 31 December 2018). A provincial government emergency medical service (EMS) was sampled. Reports were analysed and descriptively summarised with eligibility criteria based on clinical findings indicative of ACS.</p><p><strong>Results: </strong>A total of 975 ACS cases were included in the study. Extracted data were representative of a proportion of higher acuity cases, comprising red code (n = 869, 89.1%) and orange code (n = 106, 10.9%) patient groups. STEMI was identified in 43 (4.4%) of cases, although deemed attributable to poor utilisation of electrocardiograms (ECGs) in order to support diagnosis, with no findings recorded in 787 (80.7%) of cases. Following STEMI diagnosis, aspirin was administered in fewer than half of all cases (n = 17, 39.5%).</p><p><strong>Conclusion: </strong>Diagnostic 12-lead electrocardiography (ECG) is central to clinical decision-making in patients presenting with ACS, and limited utilisation could affect activation of referral pathways and delay reperfusion, ultimately worsening clinical outcomes. Further research is required to assess competencies, governance frameworks, and the availability of equipment. Despite low cost and high efficacy, aspirin was administered sub-optimally, raising doubt about clinical guideline adherence or uncertainty in diagnostic capabilities.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"570-579"},"PeriodicalIF":0.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}