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Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S27
AFRICA
Special features of acute coronary syndrome in Ramadan: Prospective study of a North-African population
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
Data on the effect of Ramadan on coronary heart disease are rare and controversial. The purpose of our survey is to determine the impact of
Ramadan on the prevalence of acute coronary syndrome (ACS) in a population of patients followed in our cardiology department.
Methods:
This is a prospective study, carried out at the Department of Cardiology and Vascular Diseases in our setting during 2 successive Ramadan periods
(2017 - 2018) for a duration of 3 months (1 month before, 1 month during and 1 month after Ramadan). We included all patients admitted for ACS during the
study period. The data were collected on a standardised form. We performed a mono- and multivariate analysis of the results.
Results:
During the 6-month period of the study, we included 153 patients admitted for ACS with (43%) and without (57%) ST-segment elevation. The
prevalence of ACS amongst hospitalised patients over this period was 15% a month before Ramadan, 19% during Ramadan and 27% a month after Ramadan.
According to the results of the multivariate analysis, the risk of ACS is not increased in the Ramadan month, and is greater during the following month. In a
subgroup analysis of the population of patients with ACS occurring during the month of Ramadan, we found an increased risk of ACS in men over 60 years
of age, and those with hypertension or diabetes. The period including Ramadan and the month following it is not associated with an increased risk amongst
subjects with no more than 1 cardiovascular risk factor (other than age, hypertension and type 2 diabetes).
Conclusion:
The prevalence of ACS is not increased in the month of Ramadan, except in elderly hypertensive and diabetic patients. The increased risk of ACS
the following month can be explained by the inadequate lifting of the dietary restriction. More studies need to be done to better explain this difference in
prevalence.
Peripheral arterial disease of the lower limbs in Moroccan hypertensive non-diabetic patients, prevalence and determining
factors: Prospective survey of 273 patients
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
Peripheral arterial disease (PAD) of the lower limbs is just a single aspect of the multivessel disease. It announces cardiovascular accidents. The
early screening of PAD is a major issue. The purpose of this study was to evaluate the prevalence of PAD of the lower limbs in asymptomatic patients with
hypertension, and to determine risk factors, or associations of risk factors, most frequently responsible for the pathological ankle-brachial index (ABI) (<0.9).
Methods:
We conducted a prospective survey, of 13 months’duration from November 2016 - December 2017, in Mohammed the VIth University Hospital of
Marrakech, Morocco. A total of 273 hypertensive patients followed-up in this setting were included.
Results:
The mean population age was 62.09 years (27 - 88 years), with a male predominance (67.76%). The prevalence of PAD was 28.94%. Risk factors, or risk
factors significantly associated with PAD (Chi-square Pearson test), are: • Male gender 72%. • Tobacco use 56%. • Obesity (BMI>=30) 15.8%. • Dyslipidemia and
grade 3 hypertension 23.4%
Conclusion:
PAD of the lower limbs is a particular location of the atheromatous process as well as a marker of its diffusion. As a result of this study, we
recommend the screening of asymptomatic PAD in all hypertensive patients by measuring the ankle-brachial index.
Evaluation of patients’ knowledge regarding the management of their treatment with Vitamin K Antagonist drugs:
Prospective study of about 100 patients
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
Vitamin K antagonists (VKA), the most widely prescribed oral anticoagulant treatment, carries a significant iatrogenic risk, often secondary to
insufficient information shared with patients regarding the management of their treatment.
Methods:
This was a descriptive cross-sectional survey conducted at our medical centre. A questionnaire (19 items) was administered to patients who had
recently been on VKA (for at least 1 week) on 3 short assessment visits at an approximate 1-month interval. We evaluated their initial knowledge level and
then recorded the evolution of their knowledge through 3 assessment sessions. During this period all patients received normal care from their attending
physician. Duration of the study was 29 months, including recruitment and monitoring of patients (January 2015 - May 2017).
Results:
One hundred patients were included in the study, 47 men and 53 women. The average age was 38 ± 16 years old. Valvular diseases and venous
thromboembolism justifying the institution of VKA treatment were noted in 35% and 27% of cases, respectively. Thirty-nine percent of patients indicated
that they had not received information regarding their treatment. The names of the VKA and the exact reason for the treatment were known in 25% and 30%
of cases, respectively, at the first consultation. Thirty-six patients cited INR as a laboratory-based monitoring of treatment and only 28 patients were aware
of the target values. The majority of patients were unaware of the risks of overdose (60%) and underdosing (52%). Nonsteroidal anti-inflammatory drug self-
medication was reported by 26 patients. A positive evolution of knowledge at the end of the study was noted in only 58 patients, but with an average score
not exceeding 09 ± 2/19 items.
Conclusion:
Patients’knowledge of VKA management was fragmentary and insufficient to ensure safe and effective treatment. At the end of this study, we
created an information booklet regarding the monitoring of patients under VKA in French and Arabic.