AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 56 Submission ID: 1083 SILENT MYOCARDIAL ISCHEMIA: CLINICAL PROFILE AND PROGNOSTIC Fares Araiez, Nour Cherif, Rym Hentati, Rym Ben Romdhane, Sofien Zayed, Kaouther Bachraoui, Rami Tlili, Youssef Ben Ameur Monji Slim Hospital, Tunisia Introduction: Silent myocardial ischemia (SMI) is defined by the presence of objective evidence of myocardial ischemia in the absence of angina pectoris or other anginal equivalents. It is characterized by the multitude of clinical presentations it can put on. Its management has not been consensually established due to the divergent results of the studies conducted regarding its treatment and the outcomes that follow. The aim of our study was to establish the clinical profile and the prognosis of patients with SMI. Methods: A single-center longitudinal descriptive retrospective study conducted at the cardiology department of Mongi Slim la Marsa Hospital from January 2015 to May 2020, including 94 cases of SMI confirmed by coronarography. Results: We included 94 patients in our study. The average age was 64 ± 9 years. We noted a clear male predominance with a sex ratio equal to 3. The most common cardiovascular risk factor was arterial hypertension (65%) then smoking (61,7%), diabetes (60%) and finally dyslipidemia (32%). The most common chief complaint was dyspnea (63%), followed by palpitations (18%) then faintness MODERATED POSTER SESSION 4 Submission ID: 1044 ROLE OF POST-MORTEM TROPONIN I TESTING IN THE DIAGNOSIS OF SUDDEN CARDIAC DEATH: A PROSPECTIVE STUDY Elaa Chebbi, Said SAADI, Imen EL AINI, Sami BEN JOMAA, Ibtissem BEN ALI, Nidhal HAJ SALEM Department of Forensic Medicine, Fattouma Bourguiba university Hospital, Monastir, Tunisia Background: Sudden death is a frequent situation in forensic pathology where an autopsy is required to find the cause of death. However, autopsy has its own limits, and diagnosing the cause of death is not always as easy as expected especially when no macroscopic lesions are found. Additional complementary techniques are therefore performed, such as histological examination. Nevertheless, when death happens fast, cardiac lesions remain hard to spot whether macroscopically or histologically. From this point, arises the need of a biochemical marker to ease the diagnose of the sudden cardiac death. Objectives: Find the correlation between troponin Ic rates in pericardial fluid, peripheral blood, and cardiac flood as well as cardiac origin of death. Material and methods: It is a prospective study, performed in the Forensic Medicine Department in Fattouma Bourguiba Teaching Hospital of Monastir during 3 years. Our study group was a 72-cases-group of sudden death. An autopsy was performed on each of the cases, as well as a histological examination of heart tissue. During the autopsy, we took cardiac and peripheral blood samples and a pericardiac fluid samples, for troponin dosage. After autopsy and histological examination, the study group was divided into two groups: 32 cases of confirmed cardiac death, 40 cases of non-cardiac death. On another time of the study, we divided the group into another two groups according to the presence of histological myocardial lesions. Correlations between TnIc level and the cause of death were analysed with Receiver-operator characteristic (ROC) curves and a statistical study was performed using SPSS (20,0 version). Results: We have found a significant correlation between Cardiac troponin I levels in pericardial fluid, cardiac and peripheral blood and subjects with observable signs of myocardial damage and those without (P value respectively at 0.0007, 0.0009 and 0.004). ROC curves analysis indicates that the pericardial fluid has the best sensibility and specificity with a cut-off level at 108ng/ml and an area under the curve at 0.925. Conclusion: The dosage of TnIc in post-mortem, mainly in pericadiac liquid is a great support of the diagnosis of a myocardial injury causing the death specially in cases where the post-mortem morphological findings are inconclusive. Submission ID: 1047 STENT VISUALIZATION ENHANCEMENT : PREDICTORS OF GOOD IMAGE QUALITY BEN AHMED HABIB, Mohamed Salmen AISSA, Aymen FTINI, Emna ALLOUCHE, Hakim Ben JEMAA, Mohamed BEJI, Faten BOUDICHE, Wejdene OUCHTATI, Leila BEZDAH Cardiology Department, Charles Nicolle Hospital, Tunis, Tunisia Background: Stent underexpansion is associated with unfavorable outcomes following Percutaneous Coronary Intervention (PCI). Intracoronary imaging techniques such as intravascular ultrasonography (IVUS) and optical coherence tomography (OCT) remain the gold standard to assess stent deployment but they are rarely available in developing countries. Although often underused, Stent Enhancement is a simple and quick tool that significantly improves the visualization of deployed stents without a significant increase in radiation dose. Objectives: We aimed to determine the predictors of failure to obtain good image quality with stent enhancement after PCI. Methods: We conducted a prospective study from a series of 90 stented lesions in 53 patients revascularized on the native vessels in the cardiology department of Charles Nicolle Hospital-Tunis. After each procedure, a StentViz (GE Healthcare on Innova 2100) was performed to make a decision of the need for post-expansion. Stent visibility was assessed using a quality score graded from 1 to 3 (1: poor visualization Stent invisible; 2: suboptimal visualization Edge Stent visible; 3: optimal visualization, Edge Stent and stitches visible). Results: The study population included 36 men and 17 women with a mean age of 62.3 years ± 8.2 years. Smoking and hypertension were the most common risk factors, they accounted for 60.4% and 39.6% respectively. PCI was performed for myocardial infarction in 73.6 % of cases and stent implantation was performed for 90 lesions. The StentViz quality score was 25.6% of cases equal to 1; 41.1% equal to 2 and 33.3% equal to 3. The failure of StentViz, defined as a non-visible stent was observed in 23 of PCI. The predictors of failure StentViz were: dyslipidemia (p = 0.039),lesions in the RCA (p = 0.046), calcified lesions( p = 0.017),the complex lesions(p = 0.033) and the diameter of the stent ( p= 0.031) Conclusion: Post angioplasty assessment of adequate stent expansion with StentViz system is easy-to-use, and time and cost-saving. In this study, Complex lesion, calcified lesion, small stent and RCA lesions were predictors of Stent enhancement visualization failure with StentViz.
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