Multi-vessel coronary artery disease (CAD) is recognized as a predictive factor of death in CAD. The aim was to assess the prevalence and predictive factors of multivessel CAD in a catheterization laboratory in Côte d’Ivoire.

Over a period of 8 years (April 2010 and January, 2018), we conducted a cross-sectional study in the catheterization laboratory of Abidjan Heart Institute. We enrolled one thousand and nineteen patients (1019) who underwent coronary angiography in the Registre Prospectif des Actes de Cardiologie Interventionnelle de l’Institut de Cardiologie d’Abidjan (REPACI). We analyzed and compared data in patients with and without multivessel CAD. Predictive factors were determined by multivariate logistic regression.

Prevalence of multi-vessel CAD was 29.7% (302 patients). Means age was 58 yo with male predominance (87.7%). Main risk factors were hypertension (66.4%), diabetes (34.2%), dyslipidemia (33.9%). Left ventricle systolic dysfunction was reported in 28.9% of patients. Left anterior descending artery was involved in 90.4% of cases. After multivariate logistic regression, age>50 yo (HR=1.9; P=0.02), diabetes (OR=1.7; P=0.01), previous percutaneous intervention (PCI) (OR=2.53; P=0.0001), chronic renal failure (OR=4.99; P=0.01), and type B2/C lesions (OR=2.12; P=0.001) were independant predictive factors of multi-vessel CAD. Among the 302 patients with multi-vessel CAD, 81 patients (27%) were eligible for coronary artery bypass graft surgery (CABG) but it was performed in 11 patients only.

Multivessel CAD is frequent in our context. Management of these patients in Subsaharan Africa needs heart teams with trained interventional cardiologists and cardiac surgeons, and equipped healthcare facilities.