CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 41 AFRICA Submission ID: 1020 OUTCOMES AND PROGNOSIS OF PATIENTS ADMITTED FOR NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION fares ammar, aymen ben abdesslem, Anis ghariani, semah Afli, Abdallah Mahdhaoui, Gouider jridi UHC Farhat Hached, Tunisia Background: Evidence-based guidelines have been published for optimal management of acute coronary syndromes. We aimed to evaluate outcomes of patients admitted for non-ST segment elevation myocardial infarction (NSTEMI) in order to identify prognostic factors. Methods: From January 2017 to December 2020, patients, admitted in our center for NSTEMI, were enrolled. They were followed-up for one year. Major cardiac events (MACEs) were defined as the occurrence of cardiovascular death, myocardial infarction, target vessel revascularization or target lesion revascularization. Results: A total of 250 patients were included. One-year mortality was 8%. After multivariate logistic regression, independent predictors of one-year mortality were: history of myocardial infarction [Odds ration (OR)= 3.7; confidence interval at 95% (95% CI) 1.23 - 11.75; p=0.02], high bleeding risk patients according to ARC HBR classification [OR= 3.61; 95% CI 1.16 - 11.15; p=0.026), Grace score higher than 142 [OR= 12.15; 95% CI 3.11 - 47.37; p=0.001], delayed angiography (>72hours) [OR= 3,99; 95% CI 1.25 - 12.47; p=0.019) and multi-vessel disease (OR= 4.41; 95% IC: 1.08 - 10.49; p=0.036]. One-year MACEs were observed in 23.6% of patients. Independent predictors of one-year MACEs identified with multivariate logistic regression were: anemia [OR= 2.9; 95% CI 3.23 – 12.6; p=0.002], dyslipidemia [OR= 2.34; 95% CI 1.09 – 5; p=0.028] and GRACE score higher than 142 [OR= 6.32; 95% CI 3.11 - 47.37; p =0.001]. Conclusion: Our study suggested that NSTEMI patients still have poor longterm outcomes in our center. Further efforts should be provided to improve their prognosis. Submission ID: 1028 MYOCARDIAL CLEFTS, SHOULD WE BE WORRIED? Yasmine Hajri, SARRA CHENIK, Yassine JABLOUN, Houaida Mahfoudhi, Wafa Fehri Cardiology department, Military Hospital of Tunis, Tunisia Myocardial clefts or crypts are a rare congenital abnormalities and could be described as an invagination penetrating >50% of the thickness of adjoining compact myocardium in diastole. However, the cleft during systole presents a narrowing or a complete occlusion. Besides, it is commonly seen in the basal inferior wall of the left ventricle and the mid to apical segments of interventricular septum. We describe a case of 29-year-old male with a personal history of cluster headache without any familial history of HCM, who is suffering from chest pain and palpitations since 5 years. Cardiac exam and the electrocardiogram were without particularities. The patient underwent a coronary CT angiogram to explore his symptomatology which confirmed the absence of any coronary artery disease but revealed the presence of an inferoseptal myocardial crypt. A transthoracic echocardiogram performed to further characterize this finding showed a normal wall motion. A discrete myocardial cleft was seen in the mid-inferoseptal wall. On reviewing the literature, these structural abnormalities like Submission ID: 1031 PERCUTANEOUS CORONARY REVASCULARIZATION BEFORE TAVR: IS IT REALLY BENEFICIAL? Amira Talhaoui, Sarra Chenik, Aymen Noomen, Taha Yassine Jabloun, Abdeddayem Haggui, Nadhem Hajlaoui, Wafa Fehri Cardiology department, Military Hospital of Tunis, Tunisia BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to manage patients with severe aortic stenosis who are not suitable for surgery that frequently present a coronary artery disease. When indicated, coronary revascularization may have an impact on clinical presentation and prognosis over the medium and long term. METHODS: This is a retrospective and descriptive study of patients undergoing TAVI who were hospitalized at the cardiology department between November 2013 and February 2020. This study sought to show the impact of the percutaneous coronary revascularization on clinical presentation and complication following TAVI. RESULTS: In our study, we included 50 patients, 13 of whom had coronary angioplasty prior to TAVI. Their most frequent reason for consultation was exercise dyspnoea (11 cases/13, p=0.08). On the other hand, they had less syncope (1case/13, p=0.05). Following TAVI, it was noted that anterior revascularization was less at risk of left anterior hemiblock (5cases/13, p=0.03), ventricular rhythm disorders (1case/13, p=0.07), acute coronary syndrome (1case/13, p=0.08), major vascular complications (6cases/13, p=0.08)and per procedural death(1cas/13, p=0.08). For long-term death no significant difference from the general population was found (p=0.54). CONCLUSION: The beneficial impact of coronary angioplasty on coronary artery disease and associated TAVI is still being discussed. Most registries show an identical 1-year prognosis for completely revascularized patients or not. MODERATED POSTER SESSION 3 Submission ID: 1035 INTERATRIAL BLOCK MIMICKING A PREEXCITATION SYNDROME IN PATIENT WITH ATYPICAL FLUTTER ADMITTED FOR WIDE QRS TACHYCARDIA NOAMEN AYMEN, Tlili Ghassen, Chenik Sarra, Haggui abdeddayem, Hajlaoui Nadhem, Fehri Wafa Military hospital of Tunis, Tunisia Introduction: Interatrial conduction defects are common in clinical practice. 1st degree of interatrial block (IAB) (mere prolongation of P waves ≥120 ms) often related to left atrium (LA) enlargement, are well known. Higher degrees of IAB may be underdiagnosed and sometimes confounded with other ECG patterns. myocardial clefts or crypts represented early pathological alteration of the myocardium and might precede manifest hypertrophy in HCM mutation carriers. Indeed, the clefts were much more prevalent in the phenotypically negative HCM patients (without LV hypertrophy). This strong association between myocardial clefts and HCM confirm the importance of a long-term follow-up in order to investigate their clinical significance. In addition to that, myocardial clefts must be recognized from LV diverticulum, pseudoaneurysm and true LV aneurysm which are prone to rupture and carry a high risk of mortality.
RkJQdWJsaXNoZXIy NDIzNzc=