AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 52 MODERATED POSTER SESSION 4 Submission ID: 1154 RELATIONSHIP OF LIPOPROTEIN (A) AND LOW-DENSITY LIPOPROTEIN (LDL) CHOLESTEROL WITH GENSINI SCORE IN CORONARY ARTERY DISEASE Bouzidi Nadia, Gamra Habib, Ferchichi Salima Clinical and molecular biology unit (UR 17ES29) – University of Monastir – Faculty of Pharmacy, Tunisia Background: Elevated levels of lipoprotein (a) (Lpa (a)) and low-density lipoprotein (LDL) cholesterol cause alterations associated with increased risk of atherosclerotic cardiovascular disease (CVD). Lp (a) is an LDLlike particle covalently bound to the glycoprotein apolipoprotein (a) (apo (a)) and has atherothrombotic and proinflammatory properties. Various angiographic scoring classification systems exist to provide an objective quantification of CAD, including the Gensini Score. We investigated the relationship of Lp (a) and LDLc concentrations with the severity of coronary artery disease (CAD). Material & Methods: A total of 310 subjects were recruited for suspected or known coronary atherosclerosis at the department of cardiology in Fattouma Bourguiba Hospital. Based on the median of GS, CAD subjects were separately divided into two groups, low GS (<40), and high GS (≥40). LDLc was estimated by the Friedewald equation and Lp (a) measurements were carried out by means of the turbidimetric method (Cobas Integra 600, Roche). We used Statistical Package for Social Sciences (SPSS, version 23.0), for data analysis. Results: Lp (a) levels ranged from 2.3 to 2258.0 mg/mL, median = 110.0 mg/ mL and LDL levels ranged from 0.1 to 6.7 mg/mL, median = 2.6. High levels of Lp (a) and LDL were not significantly associated with high levels of Gensini score (>40) (p=0.282; p=0.575). Moreover, high levels of Lp (a) and LDL were not significantly associated with stenosis degree and diseased vessels number. Conclusion: Although Lp (a) and LDLc are important risk factors for atherosclerosis, their atherogenesity didn’t show significant association with the severity of CAD according to GS. Lp (a) and LDLc levels might not contribute to the assessment of patients at high cardiovascular risk probably because of their proinflammatory effects and lipid-lowering drugs use. Submission ID: 1115 STEMI AND DIABETES: MANAGEMENT AND IN HOSPITAL MORTALITY SKANDER BOUCHNAG, MEJDI BEN MESSAOUD, YASSINE KALLELA, NIZAR IBN MECHRI, MEHDI BOUSSAADA, NIDHAL BOUCHAHDA, MAJED HASSINE, MARWEN MAHJOUB, FETHI BETBOUT, HABIB GAMRA CARDIOLOGY A DEPARTEMENT, FATTOUMA BOURGUIBA UNIVERSITY HOSPITAL, MONASTIR, TUNISIA Introduction: Diabetes is a major cardiovascular risk factor of coronary artery disease including STEMI. A better understanding of the in-hospital mortality risk factors is necessary Aim: The objectives of our study were to detail the management of diabetic patients admitted for STEMI and to specify their intra-hospital prognosis Materials and methods: it was a retrospective study including diabetic patients admitted for STEMI. These patients were selected from the MIRAMI (MonastIR Acute Myocardial Infarction) registry which included 2021 patients admitted for STEMI in the cardiology department of Fattouma Bourguiba university hospital during the period between January 1995 and December 2019. Results: Our study included 791 diabetic patients ( 39.1% of the MIRAMI registry population). The mean age was 60.68 ± 11.13 years with a marked male predominance (75%). Urgent reperfusion therapy (59,8% vs. 51,9% ; p<0.001), with PAMI (24.4% vs 23.8%; p=0.403) or thrombolysis (28.1% vs. 35.4%; p<0.001), was less indicated in diabetic patients (p<0.001). However, there was a significant tendency to increase the indication of PAMI and out-of-hospital thrombolysis in diabetic patients over the years of study (p=0.02 et 0.001 respectively). The success of thrombolysis (49.5 % vs 35.8 %; p < 0,001) and PAMI (90.1 % vs. 90.4 %; p= 0.906) was less frequent in diabetic patients. In the setting of diabetes, multivessel coronary artery disease was more frequent (p=0,007). Concerning in-hospital prognosis, hemodynamic complications (heart failure and cardiogenic shock) and mortality were significantly higher in the presence of diabetes (p<0.001, p=0.015 et p<0.001 respectively). Independent predictors of this morality were: heart rate greater than 100 bpm on admission (p=0.011), PAMI failure (p<0.001), VT (p=0.032), VF (p=0.006) and cardiogenic shock (p=0.002). Conclusion: our study showed that diabetic patients admitted for STEMI are less frequently reperfused and they have a worse in-hospital prognosis compared with non-diabetec patients. Submission ID: 1137 THROMBOLYSIS IN ACUTE MYOCARDIAL INFARCTION :MONASTIR EXPERIENCE SKANDER BOUCHNAG, MEJDI BEN MESSAOUD, YASSINE KALLELA, NIZAR IBN MECHRI, MEHDI BOUSSAADA, NIDHAL BOUCHAHDA, MAJED HASSINE, MARWEN MAHJOUB, FETHI BETBOUT, HABIB GAMRA CARDIOLOGY A DEPARTEMENT, FATTOUMA BOURGUIBA UNIVERSITY HOSPITAL, MONASTIR, TUNISIA Introduction: Thrombolysis has become a well-established alternative in the management of acute myocardial infarction (AMI). The timing of the initiation of thrombolytic agents is important in determining outcomes. AIM: We report our experience in establishing thrombolysis as a routine part of themanagement of patientswith AMI through theMIRAMI (MonastiR Acute Myocardial Infarction ) registry; with particular reference to the effectiveness of the policy, safety and delays in administration. Patients and Method: The MIRAMI registry is a single centre registry, including 1686 patients admitted for AMI from January 1995 to December 2015. Results: Thrombolysis represented 34.3% (578 patients). The majority of these patients were male (85.3%), and the mean age was 58.48 ± 12.23. The most prevalent cardiovascular risk factors were smoking (71.8%), diabetes mellitus (32.2%), and systemic arterial hypertension (28.7%). The mean interval between onset of infarction symptoms and initiation of thrombolytic therapy was 3,92 ±2,79 h, however, more than half (55, 7%) were treated before 3 hours. Prehospital thrombolysis represented 37.2%, with a statistically significant (p <0.001) increase over the years. The most used fibrinolytic drug was streptokinase (87.7%). The failure of thrombolysis was observed in 73 cases (12.6%) requiring rescue angioplasty. The complications rate was 9.5%, essentially represented by hypotension (30 patients ), and bleeding (23 patients). Two cases of allergic reactions have been reported. The mortality rate was 8% (46 patients). Age, the use of vasopressor drugs, and artificial ventilation were the independent predictors of mortality. Conclusion: Thrombolytic therapy very often is the only way in treating acute myocardial infarction. Data of our hospital experience do not dramatically differ from worldwide data. More efforts should be made to improve thrombolytic delivery times.
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