AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 70 decompensation, 2 for NSTEMI, and a single patient who presented with STEMI. There were 2 recurrences of ST classified as late ST during angiographic exploration of these patients. Seven of these patients required revascularization of the target lesion. Conclusion: To conclude this work, we note that ST has identified a subgroup of patients with a high mortality rate, suggesting that the management of these patients should be improved. Submission ID: 1766 ANGIOGRAPHIC PROFILE OF PATIENTS OVER THE AGE OF 75 YEARS OLD PRESENTING WITH ACUTE CORONARY SYNDROME TLILI RAMI, LAGHA ELYES, AZAIEZ FARES, KHALIFA ROUAIDA, BAHRI SAFA, BEN ROMDHANE RIM, BEN AMEUR YOUSSEF TUNISIA Introduction: Cardiovascular diseases are the leading cause of death globally, taking an estimated 17.9 million lives each year. As a consequence of prolonged life expectancy, the number of older patients with symptomatic coronary artery disease is constantly increasing. The aim of our study was to describe the angiographic profile of patients aged over 75 years old and treated for acute coronary syndrome (ACS). Methods: Thiswas a descriptive retrospective cross-sectional study conducted over a period of three years, from January 1, 2018 to March 31, 2021 including 100 patients over the age of 75, hospitalized for an ACS in the cardiology department of Mongi Slim-La Marsa hospital and having been treated by coronary angioplasty. Results: All our patients had undergone coronary angiography with an average delay of 3 days. The radial approach was the preferred approach, used in 78% of cases. The left anterior descending artery (LADA) was the most affected artery in 90% of cases. The left main was responsible for the infarction in 7% of cases, the LADA in 59% of cases, followed by the right coronary artery in 22% of cases and the circumflex in 12% of cases. Calcified lesions characterized 35% of the total lesions. Bifurcation lesions represented 18% of the total lesions with a predominance of the Medina 1-0-1 class. The right coronary artery was dominant in 80% of cases. Significant stenosis of the left main was present in 16% of our patients with associated three-vessel involvement in 7% of cases. Conclusion: The angiographic profile of our population was characterized by the spread of coronary involvement and the complexity of the lesions. Submission ID: 1767 MID AND LONG-TERM FOLLOW-UP OF PATIENTS AGED OVER 75 YEARS WITH ACUTE CORONARY SYNDROME TLILI RAMI, LAGHA ELYES, AZAIEZ FARES, KHALIFA ROUAIDA, BAHRI SAFA, BEN ROMDHANE RIM, BACHRAOUI KAOUTHER , BEN AMEUR YOUSSEF TUNISIA Introduction: Acute coronary syndrome (ACS) in patients aged over 75 years has become a very frequent situation as a consequence of prolonged life expectancy, and poses specific problems, diagnostically, therapeutically and prognostically. In our study, we aimed to assess the mid and long-term prognosis Submission ID: 1770 ST-SEGMENT-ELEVATION MYOCARDIAL INFARCTION IN COVID-19 AZAIEZ FARES, MLIK AHMED, KHALIFA ROUAIDA, DRISSAMARIEM, BAHRI SAFA, LAGHA ELYES, BEN ROMDHANE RIM, TLILI RAMI, BEN AMEUR YOUSSEF TUNISIA Introduction: The Severe Acute Respiratory Syndrome Coronavirus-2 have been associated with cardiovascular adverse events including acute myocardial infarction due to a prothrombotic and hypercoagulable status, and endothelial dysfunction. Case report: We report the case of a 62-year-old women, admitted to the hospital via the emergency room for acute chest pain and dyspnea. A nasopharyngeal swab was positive for COVID19 real-time reverse transcriptase–polymerase chain reaction 11 day ago. On admission, she was hypotensive with systolic blood pressure measering 87 mmHg and tachycardic with 117 beats/min, oxygen saturation (SO2) was 94%. An 18-lead ECG revealed an infero-postero-lateral ST-elevation myocardial infarction with right ventricular involvement and a seconddegree-Mobitz Type 1 atrioventricular block. The coronary angiography from the right femoral artery showed acute thrombotic occlusion of the first diagonal branch with TIMI 0 flow and acute thrombotic occlusion of proximal right coronary artery with TIMI 0 flow. The most likely diagnosis was myocardial infarction secondary to a non-atherosclerotic coronary occlusion. The angioplasy was performedwith dilatations with a semi compliant balloon, bailout implant of BMS, manual thrombus aspiration and intracoronary injection of tirofiban in the right coronary artery. The myocardial revascularization was ineffective. The patient developed significant severe hemodynamic instability and cardiac arrest for pulseless electric activity after 24 hours. Conclusion: The COVID-19 outbreak implies deep changes in the clinical profile and therapeutic management of STEMI patients who underwent PCI. At present, the natural history of coronary embolism is not well understood; however, the cardiacmortality rate are hight. This suggests these patients require further study to identify the natural history of the condition and to optimize management to improve outcome. of patients over 75 years old treated for ACS and who had undergone coronary angioplasty. Methods: This was a descriptive retrospective cross-sectional study conducted over a period of three years, from January 1, 2018 to March 31, 2021 including 100 patients over the age of 75, hospitalized for ACS in the cardiology department of Mongi Slim-La Marsa hospital and having been treated by coronary angioplasty. Results: The median follow-up for all patients was 20.7 months. The major adverse cardiac events rate was estimated at 39%. 7% of patients died of cardiovascular causes, myocardial reinfarction was noted in 24% of patients, 1 case of stroke (1%) was noted, 7% of patients had presented an acute heart failure and 28 patients had an angina recurrence. Coronary angiography did not reveal any change in coronary status in 4 patients and revascularization was performed in 24 patients. Rehospitalization for acute heart failure was observed in 7 patients. One patient had presented a hemorrhagic stroke 3 months post-infarction. A patient died within 1 year after the NSTEMI following a state of hemorrhagic shock refractory to treatment. Two patients had presented a complete atrioventricular block and had benefited from the implantation of a dual-chamber pacemaker. Conclusion: Ischemic heart disease is the leading cause of morbidity and mortality in this age group. The management of coronary pathology at these extreme ages remains difficult and the postoperative complications rate is higher than in the general population. MODERATED POSTER SESSION
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