CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 31 AFRICA Submission ID: 1499 CLINICAL FINDINGS AND CHARACTERISTICS OF CULTURENEGATIVE INFECTIVE ENDOCARDITIS MAHOUNGOU MACKONIA NOEL MASCHELL, ANASS MAAROUFI, ZAHRI SOUKEYNA, HABOUB MERIEM, IMAD NOUAMOU, SALIM AROUS, BENOUNA GHALI, ABDENASSER DRIGHIL, LEILA AZZOUZI, RACHIDA HABBAL MOROCCO Introduction: Culture-negative endocarditis remains a diagnostic and therapeutic challenge. The clinical features and prognosis associated with this condition may vary according to different epidemiological and clinical factors Empirical antimicrobial therapy is based on epidemiological data, although unusual microorganisms may also cause endocarditis Objective: We studied the clinical characteristics, in-hospital mortality and short-term prognosis of patients with culture-negative endocarditis. Material and method: A total of 122 episodes of definite endocarditis according to the duke criteria were studied (2014-2022). We compared clinical, laboratory and echocardiographic characteristics, as well as complications and survival rates of patients with culture-negative and culture-positive endocarditis. Results: Culture-negative endocarditis occurred in 82 (67%) episodes. Compared with patients with culture-positive endocarditis, the time from first symptoms to admission was shorter in patients with culture-negative endocarditis, a mean of 20 days compared with 30 days in the culture-positive group (p < 0.05), and these patients also had lower levels of C-reactive protein on admission (99 versus 120 mg/dl) (p < 0.05). Hospital stay was not different between the two groups with a mean hospital stay of 27 days. However, inhospital mortality rates were higher in culture-negative patients than in culture-positive patients (15% versus 11% mortality rate). As for complication rates, severe sepsis and vascular complications (stroke, splenic infarction) were higher in the culture-negative group (7.9% versus 3.1% in the culture-positive group), p<0.05. Conclusions: Patients with culture-negative endocarditis had lower levels of C-reactive protein on admission and required less time in hospital, but had a higher rate of in-hospital mortality and complications compared with patients with culture-positive endocarditis. Submission ID: 1503 BASAL CHARACTERISTICS OF THE CARDIOONCOLOGY REGISTRY OF CHEMOTHERAPY INDUCED CARDIOVASCULAR TOXICITY: ABOUT 2329 PATIENTS MAAROUFI ANASS, ABOURICHE AMIRA, BENDAHOU HAJAR, BELKOUCHIA SAMI, HABOUB MERIEM, AROUS SALIM, BENOUNA EL GHALI, HABBAL RACHIDA, TAWFIK NEZHA MOROCCO Background: Chemotherapy have improved the prognosis of many cancers in the last years but concerning cardiovascular toxicity (CVtox) have been reported. Nowadays, specific surveillance protocols are recommended , and early diagnosis of toxicity is crucial but may be challenging. Purpose: To characterize the cardiovascular (CV) effects of chemotherapy and to identify cardiovascular risk factor in cancer patients Methods: A monocentric registry was developed by collaboration of the cardiology and oncology department since 2017. A total of 2 329 patients was included. A follow-up protocol was stablished with clinical, electrocardiographic (EKG), echocardiography, and laboratory assessment, including cardiac biomarkers. Toxicity is managed according to ESC. Results: 2329 patients were currently included. Median age was 52 [35, 80] years-old, 91% were female. 65% had at least 1 CV-risk factor (75% menopause 16% hypertension , diabetes mellitus 11%, 10% hyperlipemia, 7% smoking history) and up to 4% had previous known CV disease. Dyspnoea was referred by 16% of patients, 18% have abnormal EKG findings and one-third (2%) abnormal cardiac biomarkers. Mean LVEF (58% and GLS (-18[-19.75, -15]) were within the normal range but 14% of whom LGE were measured showed reduced value at baseline. Cancer characteristics are meanly represented by breast cancer 71%; digestive 10%; hematological/ lymphoma 9%. Conclusion: Real-world cancer patients show a high CV risk profile and non negligeable CV diseases before ICI treatment. The prospective follow-up of this cohort were personalized according to baseline risk and the chemotherapy planned to detect early stages of cardiotoxicity. Submission ID: 1504 INFLUENCE OF DIRECT ORAL ANTICOAGULANTS ON RATES OF ORAL ANTICOAGULATION FOR ATRIAL FIBRILLATION MERIEM EL MOUSAID, ELAMRAOUI ASMAA, ESSADQI FADWA, AFENDI LAMIAA, HABOUBMERYEM, AROUS SALIM, BENNOUNA MOHAMED EL GHALI, AZZOUZI LEILA, HABBAL RACHIDA MOROCCO Background: Oral anticoagulation (OAC) with warfarin is underused for atrial fibrillation (AF). The availability of direct oral anticoagulants (DOACs) may improve overall OAC rates in AF patients, but a large-scale evaluation of their effects has not been conducted. Objectives: This study assessed the effect of DOAC availability on overall OAC rates for nonvalvular AF. Methods: Between April 1, 2008 and September 30, 2014, we identified 655,000 patients with nonvalvular AF and a CHA2DS2-VASc score of >1. Temporal trends in overall OAC and individual warfarin and DOAC use were analyzed. Multivariable hierarchical logistic regression identified patient factors associated with OAC and DOAC use. Practice variation of OAC and DOAC use was also assessed. Results: Overall OAC rates increased from 52.4% to 60.7% among eligible AF patients (p for trend <0.01). Warfarin use decreased from 52.4% to 34.8% (p for trend <0.01), and DOAC use increased from 0% to 25.8% (p for trend <0.01). An increasing CHA2DS2-VASc score was associated with higher OAC use (odds ratio [OR]: 1.06; 95% confidence interval [CI]: 1.05 to 1.07), but with lower DOAC use (OR: 0.97; 95% CI: 0.96 to 0.98). Significant practice variation was present in OAC use (median odds ratio [MOR]: 1.52; 95% CI: 1.45 to 1.57) and in DOAC use (MOR: 3.58; 95% CI: 3.05 to 4.13). Conclusions: Introduction of DOACs in routine practice was associated with improved rates of overall OAC use for AF, but significant gaps remain. In addition, there is significant practice-level variation in OAC and DOAC use. MODERATED POSTER SESSION
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