- Email: [email protected]
Diastolic heart dysfunction and acute coronary syndrome
22
Coronary heart disease
at the 3-year follow-up. In the whole population, adjusted for propensity score quintiles, the interventional approach group had lower mortality (hazard ratio 0.52; 95% confidence interval: 0.32—0.85) and a better survival free of ischemic events (hazard ratio 0.48; 95% confidence interval: 0.32—0.74). Conclusions Nearly all the very elderly patients admitted with non-ST segment elevation acute coronary syndrome were of moderate or high risk. In these patients, the interventional approach was associated with overall better survival and better survival free of ischemic events. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.043 353
Prognostic value of the SYNTAX and residual SYNTAX Scores in NSTE-ACS F. Boukerche ∗ , H. Aoumeur , N. Laredj , L. Hammou Cardiologie, Chuoran, Oran, Algerie ∗ Corresponding author. Adresse e-mail : [email protected] (F. Boukerche) Background The residual SYNTAX score (RSS) quantitatively assesses angiographic completeness of revascularization after percutaneous coronary intervention (PCI). Objective The purpose of this study was to determine whether the RSS could predict one-year mortality more than Syntax score in patients with NSTE-ACS. Methods Patients admitted in our cardiology department between 01 November 2015 and 31 October 2016 for NSTE-ACS and treated by PCI were prospectively evaluated. The Syntax score and the residual syntax score (RSS) were calculated. The RSS was based on the recalculation of the SYNTAX score after PCI.A ROC curves were developed to define the SS and RSS score cutoffs that best predicts one-year mortality. Results Un total de 132 patients were evaluated: mean age was 62 ± 12 years and 66.7% were male. The one-year mortality was 3.8%. The syntax score and RS score in these patients were significantly higher (27.1 ± 6.5 vs. 15.8 ± 5.2; P = 0.005) and (22.4 ± 7.9 vs. 5.2 ± 6.5; P < 10—3) respectively. Syntax score > 22 showed a sensitivity of 80.0%, specificity of 81.6%. The area under the ROC curve was 0.85 (95% confidence interval of 0.74—0.96). Residual Syntax score > 18 showed a sensitivity of 80.0%, specificity of 96.4%. The area under the ROC curve was 0.95 (95% confidence interval of 0.88—1.00) (Fig. 1). Conclusions We believe our results show that RSS more than SYNTAX score is a strong predictor of one-year mortality in patients with NSTEACS and that more extensive revascularization might improve the prognosis of these patients. However, randomized studies are needed to confirm this hypothesis. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.044
Fig. 1
ROC curve RSS-SS One-year mortality.
263
Diastolic heart dysfunction and acute coronary syndrome H. Choukrallah ∗ , S. Khaddi Cardiologie, CHU Ibn-Rochd de Casablanca, Casablanca, Maroc ∗ Corresponding author. Adresse e-mail : [email protected] (H. Choukrallah) Diastolic heart dysfunction is defined as an inability of the left ventricle to relax, distend and fill during diastole. Diagnosis of diastolic cardiac dysfunction is based on echocardiography. Assessment of left ventricular filling pressures (LVP) in the acute phase of acute coronary syndrome (ACS) is not common practice. The objective of our study is to evaluate LVP and demonstrate the prognostic value of the irassessment in the acute phase of ACS. We prospectively included 683 patients admitted to the cardiac intensive care unit of CHU Ibn-Rochd Casablanca during the year 2017, for an ACS with or without a persistent ST-elevation. All patients had transthoracic cardiac echocardiography within 48 hours of admission. The average age of our patients was 56.5 ± 18 years, with extremes of 38 and 78 years. There was a clear male predominance (sex ratio 7/2). LVP were high in 214 patients (31.3% of cases), isolated in 62 patients and associated with systolic heart failure in the remaining cases. Assessment of the LVP was a predictor of mortality (P = 0.01) and occurrence of major cardiovascular events at 6 months of followup (P = 0.001). The study of the diastolic function and especially the assessment of LVP in the acute phase of ACS makes it possible to refine the stratification of the patients admitted for ACS and to identify a group of at-risk patients likely to benefit from a more specific treatment. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.045 069
Delays in the management of acute coronary syndroms with ST segment elevation and extending factors: Prospective study about 50 cases in cardiology department of Aristide Le Dantec hospital. M. Dioum 1,∗ , I. Ka 1 , J. Mingou 2 , M.T. Diouf 2 , F.K. Aw 2 , Mouhamadou Bamba Ndiaye 2 , Maboury Diao 2 , S.A. Ba 2,∗ 1 Cardiologie, Hopital Fann, Ucad, Fmpos 2 Cardiologie, Hopital Aristide Le Dantec, Dakar, Senegal ∗ Corresponding authors.
Coronary heart disease
at the 3-year follow-up. In the whole population, adjusted for propensity score quintiles, the interventional approach group had lower mortality (hazard ratio 0.52; 95% confidence interval: 0.32—0.85) and a better survival free of ischemic events (hazard ratio 0.48; 95% confidence interval: 0.32—0.74). Conclusions Nearly all the very elderly patients admitted with non-ST segment elevation acute coronary syndrome were of moderate or high risk. In these patients, the interventional approach was associated with overall better survival and better survival free of ischemic events. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.043 353
Prognostic value of the SYNTAX and residual SYNTAX Scores in NSTE-ACS F. Boukerche ∗ , H. Aoumeur , N. Laredj , L. Hammou Cardiologie, Chuoran, Oran, Algerie ∗ Corresponding author. Adresse e-mail : [email protected] (F. Boukerche) Background The residual SYNTAX score (RSS) quantitatively assesses angiographic completeness of revascularization after percutaneous coronary intervention (PCI). Objective The purpose of this study was to determine whether the RSS could predict one-year mortality more than Syntax score in patients with NSTE-ACS. Methods Patients admitted in our cardiology department between 01 November 2015 and 31 October 2016 for NSTE-ACS and treated by PCI were prospectively evaluated. The Syntax score and the residual syntax score (RSS) were calculated. The RSS was based on the recalculation of the SYNTAX score after PCI.A ROC curves were developed to define the SS and RSS score cutoffs that best predicts one-year mortality. Results Un total de 132 patients were evaluated: mean age was 62 ± 12 years and 66.7% were male. The one-year mortality was 3.8%. The syntax score and RS score in these patients were significantly higher (27.1 ± 6.5 vs. 15.8 ± 5.2; P = 0.005) and (22.4 ± 7.9 vs. 5.2 ± 6.5; P < 10—3) respectively. Syntax score > 22 showed a sensitivity of 80.0%, specificity of 81.6%. The area under the ROC curve was 0.85 (95% confidence interval of 0.74—0.96). Residual Syntax score > 18 showed a sensitivity of 80.0%, specificity of 96.4%. The area under the ROC curve was 0.95 (95% confidence interval of 0.88—1.00) (Fig. 1). Conclusions We believe our results show that RSS more than SYNTAX score is a strong predictor of one-year mortality in patients with NSTEACS and that more extensive revascularization might improve the prognosis of these patients. However, randomized studies are needed to confirm this hypothesis. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.044
Fig. 1
ROC curve RSS-SS One-year mortality.
263
Diastolic heart dysfunction and acute coronary syndrome H. Choukrallah ∗ , S. Khaddi Cardiologie, CHU Ibn-Rochd de Casablanca, Casablanca, Maroc ∗ Corresponding author. Adresse e-mail : [email protected] (H. Choukrallah) Diastolic heart dysfunction is defined as an inability of the left ventricle to relax, distend and fill during diastole. Diagnosis of diastolic cardiac dysfunction is based on echocardiography. Assessment of left ventricular filling pressures (LVP) in the acute phase of acute coronary syndrome (ACS) is not common practice. The objective of our study is to evaluate LVP and demonstrate the prognostic value of the irassessment in the acute phase of ACS. We prospectively included 683 patients admitted to the cardiac intensive care unit of CHU Ibn-Rochd Casablanca during the year 2017, for an ACS with or without a persistent ST-elevation. All patients had transthoracic cardiac echocardiography within 48 hours of admission. The average age of our patients was 56.5 ± 18 years, with extremes of 38 and 78 years. There was a clear male predominance (sex ratio 7/2). LVP were high in 214 patients (31.3% of cases), isolated in 62 patients and associated with systolic heart failure in the remaining cases. Assessment of the LVP was a predictor of mortality (P = 0.01) and occurrence of major cardiovascular events at 6 months of followup (P = 0.001). The study of the diastolic function and especially the assessment of LVP in the acute phase of ACS makes it possible to refine the stratification of the patients admitted for ACS and to identify a group of at-risk patients likely to benefit from a more specific treatment. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.045 069
Delays in the management of acute coronary syndroms with ST segment elevation and extending factors: Prospective study about 50 cases in cardiology department of Aristide Le Dantec hospital. M. Dioum 1,∗ , I. Ka 1 , J. Mingou 2 , M.T. Diouf 2 , F.K. Aw 2 , Mouhamadou Bamba Ndiaye 2 , Maboury Diao 2 , S.A. Ba 2,∗ 1 Cardiologie, Hopital Fann, Ucad, Fmpos 2 Cardiologie, Hopital Aristide Le Dantec, Dakar, Senegal ∗ Corresponding authors.