AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 38 MODERATED POSTER SESSION 3 rhythm disorders - ventricular fibrillation/ ventricular tachycardia-) and prognostic factors associated with the occurrence of these complications, in-hospital and at 12 months. Methods: Prospective study including all patients admitted in our department for NSTEMI consenting, from January 1st, 2018 to July 31st, 2019 with a 12-month follow-up: clinical history ;risk factors, clinical, electrical, biological, echocardiographic and angiographic characteristics are collected. In-hospital and 12-month MACE and associated prognostic factors are assessed. Results: 140 patients were included .The Sex ratio was 2,3; The mean age 65,6 years; 70% were hypertensive; 54% diabetic, smoking found in 43,5% and obesity found 12.2% . Cardiovascular history: history of ACS: 19,3%; history of PCI: 16,5% ; history of heart failure: 10%; Stroke: 2,1%; CABG: 2,9%; Renal failure: 10%. KILLIP class ≥2 at admission found in 8% ; the mean GRACE score was 119 ± 24. The mean LVEF was 52.9% ± 9,6. Coronary angiography performed in 84.1% with stenting in 75%. Recommended therapies were prescribed in more than 96.9% for each therapeutic class. In-hospital results: MACE rate was 12.9%. po = 0.129; 95% CI: 0.164 ± 0.036. Mortality: 1.4%. heart failure 10%. Cardiogenic shock occurred in 2.2%. Recurrence of ACS and stroke as well as major bleeding occurred in 0.7% of cases, respectively . No cases of stent thrombosis or VT/ VF were recorded. At 12 months: MACE rate was 13,4% ; po =0.134 (95% CI: 0.134 ± 0.061). Mortality rate was 4.2%. Heart failure 5%. Stroke 4.2% , ACS 3.3%. Stent thrombosis 1.7% . Cardiogenic shock noted in 0.8%. Finally, no case of bleeding or VT / VF recorded at 12 months. Prognostic factors for the occurrence of MACE were: history of STEMI, history of heart failure, KILLIP classification ≥2 on admission, GRACE score>140 and pulmonary hypertension. Conclusion: NSTEMI remains a serious pathology despite advances in pharmacology and interventional cardiology. The reduction of its complications requires the improvement of the patient care pathway, management of comorbidities , without forgetting the cornerstone which is the reinforcement of preventive measures and the fight against risk factors in the general population from a young age. Submission ID: 1148 PREDICTIVE RISK FACTORS OF EMBOLIC EVENT IN PATIENTS WITH INFECTIVE ENDOCARDITIS Nesrine Amdouni, Ikram Chamtouri, Kais Memmi, Asma Ben Abdallah, Wajih Abdallah, Jomaa Walid, Khaldoun Ben Hamda, Faouzi Maatouk CARDIOLOGY A DEPARTEMENT, FATTOUMA BOURGUIBA UNIVERSITY HOSPITAL, MONASTIR, TUNISIA Introduction: Embolic events are a major cause of morbidity and mortality in patients with infective endocarditis (IE). Objective: To identify factors associated with the occurrence of embolic event in patients hospitalized for IE. Patients and Methods: This is a single-center retrospective study including 245 patients admitted in cardiology B department of Fattouma Bourguiba university hospital between January 2000 and December 2019, for IE. The diagnosis of IE was made according to Duke’s criteria. Results: There were 48 cases of IE complicated by an embolic event (19.6%). Right heart IE was significantly associated with a higher incidence of embolic event (p = 0.01). For left heart IE, embolic events were more frequent in mitral valve IE (45.8% vs. 31.7% for the aortic valve; p = 0.012). The occurrence of an embolic event was significantly higher in case of IE on prosthesis compared to IE on native valve (p = 0.04). Mobility and vegetation size> 10mm were associated with an increased incidence of embolic event (p = 0.013 and 0.02 respectively). In multivariate analysis, only vegetation size> 10mm was independently associated with a high risk of embolic event (OR = 3.1; 95% CI: 1.58 - 5.42; p = 0.02). Conclusion: The evaluation of the embolic risk in patients with AE remains difficult, which has a major prognostic impact. Submission ID: 1156 LEFT VENTRICULAR NON-COMPACTION CARDIOMYOPATHY: CLINICAL AND IMAGING FINDINGS Allouche Emna, Mediouni Mariem, Fathi Marwa, Boudiche Feten, Ben Jemaa Hakim, Béji Mohamed, Ouechtati Wejdène, Ben Ahemed Habib, Bezdah Leila Cardiology departement of Charles Nicolle Hospital, Tunisia Introduction: Left ventricular non-compaction (LVNC) is a rare congenital cardiomyopathy thought to be caused by the arrest of myocardial compaction during embryogenesis, leading to a non-compacted endocardial layer withmarked trabeculations. Clinical manifestations exist on a wide spectrum, from asymptomatic to the classic triad of HF, arrhythmias, or thromboembolic events. The diagnosis is primarily based on transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (MRI). Methods: We present the symptoms, echocardiographic and MRI findings of 6 patients diagnosed with LNVC. Results: The mean age was 39 ± 9 years old. Our youngest patient was a 22-year-old woman. There were 4 men and 2 women. Dyspnea was present in all 6 cases (NYHA class III-IV). Congestive heart failure signs were present in 5 of them. Only one patient had a cardiogenic shock complicating an inferior myocardial infarction and an ischemic stroke leading to a fatal end. Arrythmias were the most frequent manifestation: 3 cases presented with sustained ventricular tachycardia and 1 case had a history of paroxysmal atrial flutter. TTE showed a dilated LV and systolic dysfunction in 5 patients with a mean LVEF of 34.5%. Hypertrophy was present in 4 patients and only 2 had marked trabeculations with a ‘spongy’ look and evidence of intertrabecular perfusion proved by Color Doppler mode. Neither intracardiac thrombus nor congenital cardiac defects were found on TTE. Cardiac MRI confirmed LVNC in all 6 patients with a noncompacted to compacted myocardium ratio >2.3. Trabeculations were mostly present in the lateral wall (3 patients) and the apex (2 patients). Thrombus presence within the trabeculations was found in 2 patients. Three of our patients underwent coronary angiography which showed no significant coronary artery disease. All patient were treated with betablockers and ACE-inhibitors. Two of them underwent ICD implantation and one patient had a CRT-D device implanted. A family screening plan was set for every patient. Conclusion: LNVC is a rare disease of which the etiology and pathogenesis are still unsolved and with unpredictable outcomes. Sudden cardiac death is the most feared complication. Its therapeutic management is still challenging.
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