AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 20 Submission ID: 1098 ANALYSIS OF THE PERFORMANCE OF EUROSCORE II ACCORDING TO THE DISCRIMINATION APPROACH IN A TUNISIAN POPULATION Maatouk Amani, Imene Mgarrech, Maatouk Iyed, Taieb Cherif, Chokri Kortas, Sofiane Jerbi, Mansour Njah, Mahjoub Mohamed Hospital Hygiene Service, University Hospital Centre Farhat Hached, Sousse, Tunisia Background: Surgical risk assessment in cardiovascular surgery is essential for appropriate patient management. Numerous scores have been developed in cardiac surgery, such as the EuroSCORE II, which is the most widely used model in Europe. We aimed to evaluate the performance of the EuroSCORE II according to the discrimination approach in a Tunisian population. Methods: We conducted a retrospective cross-sectional study at the Cardiovascular and Thoracic Surgery Department of the University Hospital of Sahloul of Sousse (Tunisia) from January 2015 to December 2016 including 418 adults undergoing cardiac surgery under extracorporeal circulation. Data were collected from the archived patient records. The EuroSCORE II was calculated for each patient using the validated application on the www.euroscore. org website. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0. The EuroSCORE II performance was assessed by the discrimination analysis using the receiver operating characteristic (ROC) curve. Results: In total, 418 patients participated in the study. The majority of respondents were male (58.6%).The mean age was 55.84 ± 13.84 years. Patients underwent different types of cardiac surgery mainly represented by valve surgery (48.8%). The EuroSCORE II discriminative power analysis showed that the area under the ROC curve (AUC) was 0.864 ± 0.032 (CI 95% 0.801 - 0.927) for our population, 0.822 ± 0.061 (CI 95% 0.703-0.941) for the coronary subgroup, 0.864 ± 0.052 (CI 95% 0.762-0.967) for the valvular subgroup, and 0.900 ± 0.041 (CI 95% 0.819-0.981) for the urgency subgroup. Conclusions: Our study showed an adequate discrimination of The EuroSCORE II in the total population and in all subgroups reflecting its acceptable performance. It is therefore important to validate such models of risk stratification among patients in developing countries in order to improve their prognosis. Submission ID: 1104 ACUTE CORONARY SYNDROME CAUSED BY CORONARY EMBOLISM: ABOUT 6 CASES Ridha Fekih, Saoussen Antit, Souha Abid, Emna Rekik, Marwa Abdelhedi, Dorra Aouadi, Elhem Boussabah, Lilia Zakhama Interior Security Forces Hospital, Tunisia Introduction: Coronary embolism is a rare aetiology of acute coronary syndrome. Establishing the diagnosis represents a challenge for the interventional cardiologist. Various causes have been reported such as infectious endocarditis, mitral stenosis with left atrial appendage thrombus and atrial fibrillation. Aim: Identify the causes of acute coronary syndrome due to coronary embolism Methods: We report 6 cases of acute coronary syndrome caused by coronary embolism. Results: About the 6 patients, 5 men and one woman with an average age of 57 years [40;73]. Cardio vascular risk factors were smoking in one case and arterial hypertension in another one, no other risk factors were found. One patient presented an anterior ST-Segment Elevation myocardial infarction and 5 cases presented non ST segment elevation acute coronary syndrome with positive cardiac markers. Atrial fibrillation was detected in 5 cases, associated to severe mitral stenosis in 2 cases. Transthoracic and transesophageal echocardiography showed a spontaneous echographic contrast in the left atrium in 3 cases: associated to a left atrial appendage thrombus in 2 cases, and a thrombus regarding the posterior mitral leaflet in 2 cases. Coronary angiography was normal in 5 cases and showed a non-occlusive left anterior descending artery thrombosis which faded away after GP IIb/IIIa receptor antagonist therapy. All patients were put on oral anticoagulation treatment with favorable long term follow up. Conclusion: Coronary artery thrombo-embolism as a non-atherosclerotic cause of acute coronary syndrome is rare and should be evoked among other etiologies, mostly in presence of atrial fibrillation and mitral stenosis. Early and efficient anticoagulation treatment is essential for thromboembolic risk prevention. Submission ID: 1112 CARDIOVASCULAR RISK FACTORS AND STENT THROMBOSIS Fares Azaeiz, Ahmed Mlik, Rym Hentati, Rym Ben Romdhane, Sofien Zayed, Kaouethar Bachraoui, Rami Tlili, Youssef Ben Ameur Mongi Slim University Hospital, Tunisia Background: Stent thrombosis is a serious complication with an increased mortality rate of 40% and major sequelae of myocardial infarction in approximately 80% of survivors who remain at risk for frequent recurrence. Several factors have been associated with TS, including comorbidities, initial clinical presentations, diabetes, stent undersizing or under-expansion, complex and/or bifurcation lesions, and coronary dissections. The objective of our study is to analyze stent thrombosis and to identify the cardiovascular risk factors favoring its occurrence according to local expertise. Methods: This was a single-center retrospective study conducted at the cardiology department of Mongi Slim University Hospital La Marsa over a seven-year period from January 2013 to December 2019. we recruited 50 patients who were victims of stent thrombosis and an equivalent number of patients hospitalized in the same department and who did not develop a stent thrombosis during the first 3 years after the implantation of an endocoronary prosthesis. Our work includes a comparative section of case-control. Results: We noted a slightly older population in the cases group compared to the controls with an average of 60±10 years versus 59±10 years without a statistically significant difference (p=0.85). We found that more smoking patients in the cases group than in the controls(76% vs 62%) without this being statistically significant with the univariate study (p=0.13). Paradoxically, the average pack-year was slightly higher in the control group than in the cases (52 vs 48). The proportion of diabetics was lower in patients with stent thrombosis. There were more insulin-dependent patients in the cases (48% vs. 40%), although this was not statistically significant. The average duration of diabetes was greater in the cases (9±8 years vs. 6±7 years) without statistical significance in terms of the occurrence of stent thrombosis. MODERATED POSTER SESSION 1
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