AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 62 Results: The average age in our population was 59.7 ± 11.3 years with a male majority without any significant difference between the two groups. The DES group contained significantly more patients with diabetes (67.5% versus 38.1%; p <0.0001) and a history of coronary heart disease (40% versus 16.7%; p = 0.001). The BMS group had significantly more procedures in the aftermath of MI (18.8% versus 40.5%; p = 0.002) including more primary angioplasty (6.7% against 47.1%; p = 0.006). About two-thirds of the study patients had multivessel disease with equal distribution in both groups. The average duration of dual antiplatelet therapy was significantly prolonged in the DES group: 13.01 ± 8.31 months versus 7.59 ± 8.19 months; p <0.0001. A mean follow-up of 27.87 ± 14.82 months was obtained. At 12 months, DES led to a significant reduction in the combined rate of major cardiac events by about 70% (OR = 0.32; 95% CI: 0.119 to 0.858; p = 0.019) without allowing a significant reduction in the rates of in-stent restenosis, in-stent thrombosis, target vessel revascularization or non-combined major cardiac events. During long-term follow-up, the benefit of DES in terms of MACE was maintained by allowing a 60% reduction in the combined rate of major cardiac events (OR = 0.406; 95% CI: 0.172 to 0.955; p = 0.035). Multivariate analysis identified the BMS as an independent predictor of major cardiac events and death. However, the stent type does not appear to influence the ISR and target lesion revascularization rates. Conclusion: The results of our study demonstrate a clear clinical benefit of drug-eluting stents during angioplasty of large coronary arteries in reducing major cardiac events and death. Submission ID: 1726 VESSEL SIZE AND LONG-TERM OUTCOME AFTER PERCUTANEOUS CORONARY INTERVENTION WITH DRUG ELUTING STENT SKANDER BOUCHNAG, MOHAMED MEHDI BOUSSAADA, MOHAMED MAJED HASSINE, NIDHAL BOUCHEHDA, MEJDI BEN MESSAOUD, MARWEN MAHJOUB, FETHI BETBOUT, HABIB GAMRA TUNISIA Introduction: The role of coronary stenting with DES in the treatment of patients with small vessels is not well defined and still seems to raise controversy. Aim: The purpose of this study was to investigate the influence of vessel size on long-term clinical and angiographic outcomes after coronary DES placement. Methods and Results: The study comprised 421 patients with successful DES implantation for symptomatic coronary artery disease. Patients were subdivided into 2 groups according to vessel size, with respective ranges of > 2,75 mm and ≤ 2,75 mm. There was no significant difference between the two groups regarding of the conventional cardiovascular risk factors (sex, hypertension, smoking, dyslipidemia) except for diabetes: indeed, in the small-vessel group, there are more diabetics (72, 5% vs 59.9%; p=0.05). Furthermore, there is no noticeable difference between the two groups regarding the reasons for hospitalization. The mean follow-up duration was 26,14 ± 17,7 months. In our population, the overall mortality rate was 5%. This rate was higher in the group with smaller vessels than in the group with larger vessels (8,1% vs 3,4%; p=0,02). Rehospitalization was similar between the 2 groups (26,9% and 21,1%, respectively; p=0,106). Angiographic restenosis rate was significantly higher in the small-vessel group (21,8% vs 11,8%; p=0,04). Similarly, the rates of stent thrombosis, TVR and TVF were also significantly higher in this group (9,7% vs 2,5%, p=0,024; 14,7 vs 6,6, p=0,06; 10,3 vs 5,4, p=0,03 respectively). Conclusions: Patients with small vessels present a higher risk for an adverse outcome after coronary drug-eluting stent placement because of a higher incidence of restenosis and stent thrombosis. However, the unusually high risk for restenosis is confined to those patients with small vessels who have concomitant risk factors such as diabetes. Submission ID: 1728 RENAL ARTERY ANGIOPLASTY IN PATIENTS WITH KIDNEY FAILURE IN PATIENTS WITH SEVERE ATHEROSCLEROTIC RENAL ARTERY STENOSIS AND ISCHEMIA DOCUMENTED BY ULTRASOUND RESISTANCE INDEX: A RETROSPECTIVE STUDY OF 48 CONSECUTIVE PATIENTS ZAKARIAE LARAICHI, MARC DARRAS, STÉPHANE GRECIANO FRANCE Background: Severe arteriosclerotic stenosis of the renal artery with at least 6070% narrowing of the lumen can lead to various diseases. Renal artery stenosis may be treated by revascularization using either percutaneous (balloon angioplasty with or without stenting) or less commonly open surgical procedures, both with excellent primary patency rates of over 90%. Objective: In this context, we evaluated a cohort of patients having been revascularized by angioplasty in order to trace their evolution and to evaluate the possible benefit of this procedure. Methods: This is a monocentric, retrospective, cross-sectional study conducted in the interventional cardiology department of the Colmar Hospital Center during the period between 2012 and 2020. The 48 patients therefore included in the analyses were all with chronic kidney disease classified according to the KDIGO criteria. They had undergone a Doppler ultrasound of the renal arteries finding not only a severe stenosis, but complicated by a decrease of the resistance index (RI) of more than 5% compared to the contralateral side. Results: 56.2% of the included patients were male. The mean age of the population was 73.8±12.2 years. Almost all of the study population had hypertension (97.9%) and the mean systolic and diastolic blood pressures of the patients preoperatively were 164.5/83.9 ± 33.2/17.6 mmHg for an average number of 3.6 ± 1.5 antihypertensive drugs. The success rate of the procedure was 100%, with implantation of one stent per artery. The mean diameter of the implanted stents was 6.40±0.83 mm with a mean length of 16.22±2.72 mm. Intra-hospital follow-up shows a constant improvement in blood pressure figures, allowing control of blood pressure in all patients, although the number of antihypertensive drugs cannot be reduced immediately in all patients. One month after angioplasty, there was an immediate decrease in serum creatinine levels to 127.44 ± 33.15µmol.L-1 for a GFR of 46.52 ± 16.41 mL/min/1.73m². The possible correlation between preoperative ultrasound RI and postoperative creatinine evolution was studied. It reveals that the improvement of postoperative creatinine was greater the higher the preoperative RI (p-value = 0.004). Conclusion: The results of this single-center retrospective study show a benefit of renal angioplasty in patients suffering from kidney failure secondary to atheromatous renal artery stenosis, both in terms of renal function and control of hypertension. MODERATED POSTER SESSION
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