The initiative to investigate the management of Pericarditis in Africa (IMPI) Registry : a substudy on the causes of constrictive pericarditis and predictors of mortality in patients with constrictive pericarditis requiring pericardiectomy at Groote Schuur Hospital (The Constrictive Pericarditis Substudy)

Background: Causes of constrictive pericarditis and predictors of peri-operative outcome following pericardiectomy are not clearly elucidated, especially in Africa, where disease characteristics differ from developed countries. Furthermore, the impact of HIV/AIDS on pericardial constriction and outcomes following surgery is unknown. We set out to investigate the causes of constrictive pericarditis, the outcomes after pericardiectomy and the predictors of mortality in Cape Town, South Africa during a 22-year period of high HIV/AIDS prevalence. Methods: A retrospective review of records of all patients who underwent pericardiectomy for constrictive pericarditis at Groote Schuur Hospital from 1 January 1990 to 31 December 2012 was performed

ST-segment elevation myocardial infarction heart of Charlotte one-year (STEMI HOC-1) study: a prospective study protocol

Abstract Background ST-segment elevation myocardial infarction (STEMI) is a clinically distinguishable yet lethal sequela of ischaemic heart disease (IHD). In sub-Saharan Africa (SSA), death due to acute STEMI is increasing. In South Africa, there is a paucity of data available on the clinical outcomes of acute STEMI within one year for individuals treated in the public healthcare sector. This study primarily seeks to determine the one-year all-cause mortality rate of acute STEMI. The study also assesses the value of serum cardiac biomarkers of myocardial damage and serum uric acid in predicting all-cause mortality in STEMI. Methods This is a single-centre observational prospective cohort of all consecutive individuals presenting with an acute STEMI to the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in Johannesburg, South Africa. Research data will be sourced on admission through electronic medical records, blood laboratory results and coronary angiography reports, and at follow-up through periodic telephonic interviews and standardised echocardiograms. At least 355 eligible participants will be continuously followed over one year, and clinical outcomes will be measured 30 days, three months, six months and one year after the index hospitalisation. Discussion This study provides insights into the demographic, risk factors and clinical profiles of individuals with STEMI in South Africa. Its findings may improve the risk stratification, prognostication, and therapeutic management of STEMI patients in our setting. By comparing the clinical outcomes between the different coronary reperfusion strategies, our results may guide clinicians in providing better patient treatment, particularly in sub-Saharan Africa, where access to percutaneous coronary intervention may be limited. Furthermore, the study offers insights into the routine use of baseline serum uric acid as a potential low-cost prognostic biomarker of all-cause mortality in STEMI. Finally, this study’s findings may be of public health significance to local policymakers to aid in reinforcing primary prevention strategies and developing structured referral networks for timely coronary reperfusion of acute STEMI

Disseminated Emmonsia in an HIV-HBV co-infected man

The differential diagnoses in patients with advanced HIV/AIDS presenting with fever and systemic illness is wide and warrants both infectious and non-infectious considerations. The need to make an early and accurate diagnosis is important to effect correct therapy and thus improve outcome. We describe a patient with several co-morbidities and an unusual disseminated fungal infection

Remote Ischaemic Conditioning in STEMI Patients in Sub-Saharan AFRICA: Rationale and Study Design for the RIC-AFRICA Trial

10.1007/s10557-021-07283-yCardiovascular Drugs and Therap