- Email: [email protected]
0475 : Strategy management of myocardial infraction admitted after H12
206
Archives of Cardiovascular Diseases Supplements (2016) 8, 205-207
0475
coronary syndrome and 11 cases of lupus nephritis. Cardiac patients. Cardiac involvement is significantly related to the lupus group with dyslipidemia.
Strategy management of myocardial infraction admitted after H12
Conclusion first results show that patients who have a disturbed lipid profile are those who develop more cardiovascular events, hence the need to continue this study and to recruit more patients to assess the immunosuppressive effects on cardiovascular risk in SLE patients.
Hafdi Karim *, Anass Inchaouh, Abdelaziz Hadadi, Abdennaser Drighil, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected] (Hafdi Karim) Introduction Acute coronary syndrome with ST elevation represents the most severe form of coronary disease. Its management is based on the urgent unblocking the occluded artery. Unfortunately, about 30% of patients do not receive reperfusion strategy, because of a delay consultation. Objective To study the characteristics of patients admitted for MI after 12 H beyond the pain, and the support arrangements for this group of patients.
The author hereby declares no conflict of interest
0430 Predictors of long-term clinical outcomes in acute coronary syndrome treated with everolimus-eluting stent
Methods Single-center study conducted on 217 patients hospitalized for AMI between H12 and J5 of pain, during the period between July 2013 and July 2015.
Laura Cetran *, Edouard Gerbaud, Benjamin Seguy, Pierre Coste CHU Bordeaux, Hôpital Cardiologique Haut-Lévêque, Pessac, France * Corresponding author: [email protected] (Laura Cetran)
Results 217 patients were collected. The average age is 63.07±12.09 years, with male predominance (sex ratio 2.2). 84% of patients admitted through the emergency department. 37.7 % of patients live more than 100 km from the hospital. 36% of patients were admitted between H12 and H24. Age is the most frequent cardiovascular risk factor. 18% of our patients are older than 75 years. The Factors associated with delays consultation are age, the distance over 100 km from the hospital, the atypical nature of pain and the admission from the emergencies department. 3/4 of patients have LV dysfunction. More than half of patients is multi-truncal. The LAD is responsible for the MI in 64,5% of cases. During the hospital period, 10% of patients presented heart failure and 6% have an arrhythmia or conduction disorder. The hospital mortality was 6.95%. The patient output order contains aspirin in 98.5 % of patients, clopidogrel in 93 % of cases and a statin in 98.5 % of cases. ACE inhibitors or AIIRAs is prescribed in 78 % of cases before the beta- blocker which is prescribed in 64% of patients.
Background Everolimus-eluting stent (EES) improves long-term prognosis in patients with acute coronary syndrome (ACS) and is currently recommended over bare metal stent (BMS) in this population. Nevertheless, predictors of long-term outcomes in ACS patients treated with EES have not been evaluated in routine practice.
Conclusion The late MI seen is a real public health problem in our country. Non-revascularized patients have a poor prognosis and even more so that the necrotic area is extended. Reducing the management delay and the multi-sectoral collaboration are key to improving the prognosis.
Methods We retrospectively included patients treated with EES for ACS between June 2012 and December 2013 in our institution. Baseline clinical, biological and procedural characteristics were collected and all patients completed at least one-year follow-up. The primary endpoint was defined as the composite of target-vessel revascularization (TVR), target-vessel myocardial infarction (MI), or cardiac death at one year. Results of 447 patients included, 67 patients (15.1%) reached the primary endpoint at one year. In a multivariate analysis using Cox regression model, cardiogenic shock (HR 6.74; 95% CI [5-18.6]; p<0,001), baseline anemia, defined by hemoglobin <11g/dL (HR 2.59; 95% CI [1.5-4.5], p=0.002), history of coronary artery bypass surgery (HR 2.21; 95% CI [1.1-11.9], p=0,003) and age (HR 1.04; 95% CI [1.02-1.06], p<0.001) were independent predictors of adverse outcomes at 1 year. Conclusion in ACS patients treated with EES, cardiogenic shock and baseline anemia were the most robust predictors of long-term adverse clinical outcomes.
The author hereby declares no conflict of interest
The author hereby declares no conflict of interest
0165 Evaluation of the lipid profile in the cardiovascular risk in patients with systemic lupus erythematosus Hafdi Karim *, Abdelaziz Hadadi, Adolphe Kasongo, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected] (Hafdi Karim) Introduction the occurrence of early atherosclerosis in systemic lupus erythematosus is currently established; both groups of factors are implicated: classical risk factors and disease -specific factors (age, activity and treatment). Today cardiovascular mortality is the leading cause of mortality in SLE patients. Objective To evaluate the frequency of hypercholesterolemia; the hypoHDL – cholesterol and / or hypertriglyceridemia in SLE patients, and its relationship with cardiovascular events and other serious clinical manifestations (lupus nephritis, neurological damage ...). Methods Prospective study spread over 1 year including 58 patients with SLE followed in consultation or hospitalization in internal medicine and cardiology departments of UH Ibn Rochd of Casablanca. The study parameters are: age, sex; cardiovascular risk factors, lipid profile, clinical assessment and treatment of the disease. Results our patients are divided into 52 women and 6 men, age means is 34.42 years with a range of [16-61 years], the average duration of disease evolution is 2 years. Age as cardiovascular risk factors is reported in 2 patients, male gender in 6 cases, and obesity in 5 cases. Hypercholesterolemia was found in 3 patients; hypertriglyceridemia in 6 patients; 11 patients have hypoHDL – Lemie. The thickness intima / media evaluated in 19 patients was normal (< 1mm) and was increased only in two cases. In patients who have hypercholesterolemia and / or hypertriglyceridemia; we found two cases of
© Elsevier Masson SAS. All rights reserved.
0417 Thrombolisis with tenecteplase (metalyse) in myocardial infarction an always topical issue A. Belouaer *, T. Boukadida, R. Gheni, R. Ben Hmida, I. Rachikou, T. Ounissi, N. Barakett Hôpital Mohamed Taher Maamouri, Nabeul, Tunisie * Corresponding author: [email protected] (Amina Belouaer) Introduction ST elevated myocardial infraction (STEMI) is a common disease, which currently represents a public health problem affecting increasingly young people. Moreover, it is not always easy to access to the transluminal coronary angioplasty (TCA) therefore the importance of thrombolysis. The aim of this study was the evaluation of myocardial infraction thrombolysis by tenecteplase (Metalyse*) and to highlight the experience of a Cardiology department Nabeul’s cardiology departement a local cardiology departement in Tunisia in case of STEMI. Methods During the study period from July 2011 to December 2013, 104 patients were hospitalized in the cardiology department of Nabeul’s hopital for STEMI and thrombolysed with Metalyse. Results 104 patients had a confirmed diagnosis and had a tenecteplase thrombolysis. The average age of our patients was 55 years with a sex ratio of 8,45. The most common risk factor was tobacco. The average time between start of chest pain and admission in hospital was 4,12 hours. Two third of patients consulted in 5 hours. The average success rate of thrombolysis was 89% and 92% during the first 3 hours and 84% beyond the sixth hour. One patient had a bleeding complication postthrombolysis (CVA). Six deaths were
Archives of Cardiovascular Diseases Supplements (2016) 8, 205-207
0475
coronary syndrome and 11 cases of lupus nephritis. Cardiac patients. Cardiac involvement is significantly related to the lupus group with dyslipidemia.
Strategy management of myocardial infraction admitted after H12
Conclusion first results show that patients who have a disturbed lipid profile are those who develop more cardiovascular events, hence the need to continue this study and to recruit more patients to assess the immunosuppressive effects on cardiovascular risk in SLE patients.
Hafdi Karim *, Anass Inchaouh, Abdelaziz Hadadi, Abdennaser Drighil, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected] (Hafdi Karim) Introduction Acute coronary syndrome with ST elevation represents the most severe form of coronary disease. Its management is based on the urgent unblocking the occluded artery. Unfortunately, about 30% of patients do not receive reperfusion strategy, because of a delay consultation. Objective To study the characteristics of patients admitted for MI after 12 H beyond the pain, and the support arrangements for this group of patients.
The author hereby declares no conflict of interest
0430 Predictors of long-term clinical outcomes in acute coronary syndrome treated with everolimus-eluting stent
Methods Single-center study conducted on 217 patients hospitalized for AMI between H12 and J5 of pain, during the period between July 2013 and July 2015.
Laura Cetran *, Edouard Gerbaud, Benjamin Seguy, Pierre Coste CHU Bordeaux, Hôpital Cardiologique Haut-Lévêque, Pessac, France * Corresponding author: [email protected] (Laura Cetran)
Results 217 patients were collected. The average age is 63.07±12.09 years, with male predominance (sex ratio 2.2). 84% of patients admitted through the emergency department. 37.7 % of patients live more than 100 km from the hospital. 36% of patients were admitted between H12 and H24. Age is the most frequent cardiovascular risk factor. 18% of our patients are older than 75 years. The Factors associated with delays consultation are age, the distance over 100 km from the hospital, the atypical nature of pain and the admission from the emergencies department. 3/4 of patients have LV dysfunction. More than half of patients is multi-truncal. The LAD is responsible for the MI in 64,5% of cases. During the hospital period, 10% of patients presented heart failure and 6% have an arrhythmia or conduction disorder. The hospital mortality was 6.95%. The patient output order contains aspirin in 98.5 % of patients, clopidogrel in 93 % of cases and a statin in 98.5 % of cases. ACE inhibitors or AIIRAs is prescribed in 78 % of cases before the beta- blocker which is prescribed in 64% of patients.
Background Everolimus-eluting stent (EES) improves long-term prognosis in patients with acute coronary syndrome (ACS) and is currently recommended over bare metal stent (BMS) in this population. Nevertheless, predictors of long-term outcomes in ACS patients treated with EES have not been evaluated in routine practice.
Conclusion The late MI seen is a real public health problem in our country. Non-revascularized patients have a poor prognosis and even more so that the necrotic area is extended. Reducing the management delay and the multi-sectoral collaboration are key to improving the prognosis.
Methods We retrospectively included patients treated with EES for ACS between June 2012 and December 2013 in our institution. Baseline clinical, biological and procedural characteristics were collected and all patients completed at least one-year follow-up. The primary endpoint was defined as the composite of target-vessel revascularization (TVR), target-vessel myocardial infarction (MI), or cardiac death at one year. Results of 447 patients included, 67 patients (15.1%) reached the primary endpoint at one year. In a multivariate analysis using Cox regression model, cardiogenic shock (HR 6.74; 95% CI [5-18.6]; p<0,001), baseline anemia, defined by hemoglobin <11g/dL (HR 2.59; 95% CI [1.5-4.5], p=0.002), history of coronary artery bypass surgery (HR 2.21; 95% CI [1.1-11.9], p=0,003) and age (HR 1.04; 95% CI [1.02-1.06], p<0.001) were independent predictors of adverse outcomes at 1 year. Conclusion in ACS patients treated with EES, cardiogenic shock and baseline anemia were the most robust predictors of long-term adverse clinical outcomes.
The author hereby declares no conflict of interest
The author hereby declares no conflict of interest
0165 Evaluation of the lipid profile in the cardiovascular risk in patients with systemic lupus erythematosus Hafdi Karim *, Abdelaziz Hadadi, Adolphe Kasongo, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected] (Hafdi Karim) Introduction the occurrence of early atherosclerosis in systemic lupus erythematosus is currently established; both groups of factors are implicated: classical risk factors and disease -specific factors (age, activity and treatment). Today cardiovascular mortality is the leading cause of mortality in SLE patients. Objective To evaluate the frequency of hypercholesterolemia; the hypoHDL – cholesterol and / or hypertriglyceridemia in SLE patients, and its relationship with cardiovascular events and other serious clinical manifestations (lupus nephritis, neurological damage ...). Methods Prospective study spread over 1 year including 58 patients with SLE followed in consultation or hospitalization in internal medicine and cardiology departments of UH Ibn Rochd of Casablanca. The study parameters are: age, sex; cardiovascular risk factors, lipid profile, clinical assessment and treatment of the disease. Results our patients are divided into 52 women and 6 men, age means is 34.42 years with a range of [16-61 years], the average duration of disease evolution is 2 years. Age as cardiovascular risk factors is reported in 2 patients, male gender in 6 cases, and obesity in 5 cases. Hypercholesterolemia was found in 3 patients; hypertriglyceridemia in 6 patients; 11 patients have hypoHDL – Lemie. The thickness intima / media evaluated in 19 patients was normal (< 1mm) and was increased only in two cases. In patients who have hypercholesterolemia and / or hypertriglyceridemia; we found two cases of
© Elsevier Masson SAS. All rights reserved.
0417 Thrombolisis with tenecteplase (metalyse) in myocardial infarction an always topical issue A. Belouaer *, T. Boukadida, R. Gheni, R. Ben Hmida, I. Rachikou, T. Ounissi, N. Barakett Hôpital Mohamed Taher Maamouri, Nabeul, Tunisie * Corresponding author: [email protected] (Amina Belouaer) Introduction ST elevated myocardial infraction (STEMI) is a common disease, which currently represents a public health problem affecting increasingly young people. Moreover, it is not always easy to access to the transluminal coronary angioplasty (TCA) therefore the importance of thrombolysis. The aim of this study was the evaluation of myocardial infraction thrombolysis by tenecteplase (Metalyse*) and to highlight the experience of a Cardiology department Nabeul’s cardiology departement a local cardiology departement in Tunisia in case of STEMI. Methods During the study period from July 2011 to December 2013, 104 patients were hospitalized in the cardiology department of Nabeul’s hopital for STEMI and thrombolysed with Metalyse. Results 104 patients had a confirmed diagnosis and had a tenecteplase thrombolysis. The average age of our patients was 55 years with a sex ratio of 8,45. The most common risk factor was tobacco. The average time between start of chest pain and admission in hospital was 4,12 hours. Two third of patients consulted in 5 hours. The average success rate of thrombolysis was 89% and 92% during the first 3 hours and 84% beyond the sixth hour. One patient had a bleeding complication postthrombolysis (CVA). Six deaths were