CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 69 AFRICA Submission ID: 1762 IMPACT OF PRIOR CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH AN ACUTE CORONARY SYNDROME AZAIEZ FARES, BAHRI SAFA, KHALIFA ROUAIDA, DRISSA MARIEM, LAGHA ELYES, MLIK AHMED, BEN ROMDHANE RIM, BACHRAOUI KAOUTHER, TLILI RAMI, BEN AMEUR YOUSSEF TUNISIA Background: Patients with prior Coronary Artery Bypass Grafting have often been under represented in acute coronary syndrome clinical trials. There are relatively few data on the characteristics and long-term prognosis of these patients, in particular in Tunisia. The purpose of this study was to investigate the clinical particularities of bypass patients presenting for acute coronary syndrome and to compare the effect of coronary artery bypass grafting on the short and long-term prognosis of these patients. Methods: We performed a cohort analysis of patients hospitalized for an acute coronary syndrome in the Mongi Slim Hospital cardiology department between 2016 and 2020. The primary endpoints were in-hospital and one-year mortality. Results: A total of 506 (59 coronary artery bypass grafting and 447 noncoronary artery bypass grafting) patients were included in the analyses. Coronary artery bypass grafting patients were older and had a higher incidence of comorbidities. They were more likely to undergo percutaneous coronary intervention than to receive medical treatment only (73 vs 27%, p<0.001). The two groups had a comparable rate of rehospitalization at 3 and 6 months. In-hospital mortality was similar between groups (1.7 vs 4.5%, p=0.507). Furthermore, one-year mortality was higher in the coronary artery bypass grafting group (6.8% vs 5.3%, p=0.002). Conclusion: Among patients with acute coronary syndrome, a previous history of coronary artery bypass grafting was associated with a higher burden of comorbidities and a high-risk profile. Treatment decisions should be made on a case-by-case basis, but long-term mortality and adverse events were higher than in patients without coronary artery bypass grafting. Submission ID: 1764 ANGIOGRAPHIC FACTORS ASSOCIATED WITH STENT THROMBOSIS AZAIEZ FARES, MLIK AHMED, KHALIFA ROUAIDA, DRISSA MARIEM, BAHRI SAFA, BEN ROMDHANE RIM, TLILI RAMI, BEN AMEUR YOUSSEF TUNISIA Background: Stent thrombosis (ST) is a serious complication with an increased mortality rate of 40% and major sequelae of MI in approximately 80% of survivors who remain at risk for frequent recurrence. Several factors have been associated with ST, including comorbidities, initial clinical presentations, diabetes, stent undersizing or under-expansion, complex and/or bifurcation lesions, and coronary dissections. The objective of our study was to analyze stent thrombosis features and to identify the angiographic risk factors according to local expertise. Methods: This was a single-center retrospective study conducted at the cardiology department of Mongi Slim University Hospital La Marsa over a seven-year period from January 2013 to December 2019. We enrolled 50 patients who had ST and an equivalent number of patients hospitalized in the same department and who did not develop a stent thrombosis during the first 3 years after the implantation of a stent. Results: Angiographic finding of arterial thrombus on the index lesion was more frequent in the case group (42% versus 32%) without statistical significance (p=0.3). Paradoxically, we found more patients with coronary bifurcation lesions in the control population without statistical significance (0.19). A strong correlation existed between the occurrence of ST and the presence of severe coronary calcifications with p=0.004 in univariate analysis. The proportion of patients with ostial lesions was the same in both groups (12%). We noted a significant association between coronary tortuosity and ST (p=0.02). Conclusion: The role of complex coronary lesions in the increased incidence of ST is widely demonstrated in our study. Submission ID: 1765 PROGNOSIS OF STENT THROMBOSIS AZAIEZ FARES, MLIK AHMED, KHALIFA ROUAIDA, DRISSA MARIEM, BAHRI SAFA, BEN ROMDHANE RIM, TLILI RAMI, BEN AMEUR YOUSSEF TUNISIA Background: Stent thrombosis is a serious complication with an increased mortality rate of 40% and major sequelae of MI in approximately 80% of survivors who remain at risk for frequent recurrence. Several factors have been associated with ST, including comorbidities, initial clinical presentations, diabetes, stent undersizing or underexpansion, complex and/or bifurcation lesions, and coronary dissections. The objective of our study is to analyze the stent thrombosis and the prognosis of patients affected by this complication. Methods: This was a single-center retrospective study conducted at the cardiology department of Mongi Slim University Hospital La Marsa over a seven-year period from January 2013 to December 2019. we recruited 48 patients who were victims of stent thrombosis. The follow-up in this study was done for only the first year after ST. The primary end point was the occurrence of MACE during the follow-up period. Secondary end points were TS recurrence, cardiac mortality, target lesion revascularization (TLR), ACS occurrence, and rehospitalization for cardiovascular disease. Results: The average post-procedural hospital stay was 5±2 days with extremes ranging from 2 to 14 days. Of the 48 patients initially included, 8 patients (16.7%) were lost to follow-up. The number of patients followed up who developed MACE within 1 year of TS was 13, which is equivalent to a 31% rate. Two patients died during the same hospitalization. The first died from cardiogenic choc and the second from a poorly tolerated arrythmia followed by cardiorespiratory arrest. Of note, both of these patients were hospitalized for STEMI, and were treated with primary PCI with final angiographic failure (TIMI flow <3). Two patients died within 1 year of the TS episode by cardiogenic acute pulmonary edema (PAO). The rate of cardiac mortality within 1 year was 9.52%. In the year following the TS episode, 11 patients were rehospitalized, including 4 for stable angina, 4 for cardiac MODERATED POSTER SESSION
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