MARCH 23e26, 2017 controls patients were divided NSVT positive and negative groups. The primary endpoint was hospitalization rates during 6 months after PM controls. Results: 50 of 104 patients have NSVT in PM control day and any shock or anti-tachycardia pacing were not seen. During 6 months follow up period after PM control, 24 patients hospitalized due to decompensation. HF hospitalization was lower in the NSVT negative group versus the NSVT positive group (38% versus 62%; adjusted hazard ratio [HR] 0.166; 95% CI 0.056 to 0.492; p ¼ 0.01). Conclusions: Observed NSVT in ICD PM control may be a predictor of HF hospitalization rates and better medical treatment regulation may be beneficial in this heart failure patients for avoid hospitalization. Keywords: Non sustained ventricular tachycardia, implantable cardioverter defibrillator, hospitalization, decompensation Table
Male, n (%) Age (years, mean SD) Hypertension, n (%) Diabetes, n (%) Device CRT, n (%) ICD, n (%) Ischemic Etiology, n (%) Glucose, mg/dL Creatinine, mg/dL, Hospitalization, n (%)
Group I NSVT (-) (n¼54)
Group II NSVT (þ) (n¼50)
p
(42) (77.7) 60 10.1 25 (46) 15 (27)
(42) (84.0) 61 10.1 24 (48) 12 (24)
0.42 0.72 0.86 0.66
11 (20) 43 (80) 25 (46) 124 70.1 1.01 0.34 5 (9)
6 (12) 44(78) 30 (60) 114 40.1 0.9 0.24 19 (38)
0.24 0.16 0.40 0.63 0.001
Structural Heart Interventions And Outcomes - OP-150 [AJC » Cardiac imaging Echocardiography] PDA Closure with Paracetamol Versus Ibuprofen. Inas Abdelsattar Saad, amr Hosney Malash, Nuran Fahmy Hussein, Antoine Fakhry Abdelmasih, Rana Essam kassem. Department of Pediatrics, Cairo University, Cairo, Egypt. The aim of this work was to assess the effect of intravenous paracetamol in comparison to oral ibuprofen for closure of PDA in premature infants as well as to compare the complications and side effects of both medications. Intravenous paracetamol has shown to be as effective as oral ibuprofen in medical closure of PDA in premature infants. Regarding the safety, it is a safe drug but liver enzymes and bilirubin levels should be monitored cautiously before and after treatment. Our study is a prospective randomized control study carried on 40 preterm at Neonatal Intensive Care Unit (NICU) of Children Hospital, Cairo University. Females represented 24 out of the 40 cases (60% of the cases) while males represented 16 out of the 40 cases (40% of them). Mean age was 32.18 weeks (ranging from 26 to 36 weeks) and mean weight was 1.6 kgs (ranging from 1.1 to 2.0 kgs), mean APGAR 6.0 and mean PDA size 3.108 mm (ranging from 2.0 to 5.0 mm).
The preterm infants were randomly classified into two groups, one group received oral ibuprofen and the other group received IV paracetamol. In addition to examination, laboratory investigations, and X-ray, echocardiography was done after enrollment and also after treatment was given. Surprisingly, our results showed that paracetamol was as effective and safe as ibuprofen in treatment of PDA, 14 out of 20 cases (70%) of preterm infants ( 37 weeks) showed total closure of PDA (their mean gestational age was 32.4 weeks and their mean birth weight was 1.6 kg). In contrast to ibuprofen group in which 15 out of 20 cases (75%) showed total closure of PDA, (their mean gestational age was 31.95 weeks and their mean birth weight was 1.709kg). We concluded that intravenous paracetamol is at least as effective as oral ibuprofen in promoting ductal closure in premature infants. We recommended doing an echocardiography for all preterm infants and giving intravenous paracetamol for those with PDA. Keywords: PDA, ECHO, Paracetamol, Ibuprofen
- OP-151 [AJC » PI for SHD - Transcatheter pulmonary valve replacement] Discharge Disposition of Older Patients Undergoing Trans-catheter Aortic Valve Replacement and its Impact on Long Term Outcomes. A Propensity Scoring Matched Analysis. Alexis Kofi Okoh, Dhaval Chauhan, Nathan Kang, Nick Haik, Chunguang Chen, Mark J. Russo. Rwj Barnabas Health Newark Beth Israel Medical Center. Objective: Elderly patients with high operative risk undergoing trans catheter aortic valve replacement (TAVR) for aortic stenosis are likely to be discharged to a location other than home. We aimed to assess the association between discharge disposition after TAVR and long term outcomes. Methods: The incidence of discharge to home (DTH) vs. other location (DTOL) after TAVR was studied in TAVR-patients at a high volume center. Factors predicting the odds of being DTOL were investigated by using multivariable logistic regression analysis. With these findings, DTH and DTOL patients were matched one-to-one via a propensity scoring method. The balance between the matched groups was evaluated with appropriate statistical tests (McNemar, StuartMaxwell). Differences in procedural outcomes and long term survival of matched pairs were evaluated by using the Kaplan Meier method with the Kleine -Moesch-Berger stratified log-rank test. Results: Out of 578 patients, 371 (64%) were DTH and 201(36%) were DTOL after the procedure. Mean SD age and Society of thoracic surgeons (STS) score were 82 8 years, 8 5 respectively. Age, frailty status, STS score, and non-trans-femoral (NF) approach were significantly associated with the odds of being DTOL. Propensity score matching resulted in 140 pairs of patients with similar operative risk (8.1 4.7 vs. 8.1 5.7; p ¼0.650), frailty status (Frail: 32% vs. 30%; p¼ 0.796), NYHA class III-IV (77% vs. 79%; p¼0.740) and approach (Non-TF: 26% vs. 29%; p¼ 0.593). The incidence of paravalvular leak, post-operative stroke and the need for permanent pacemaker placement were comparable in both groups (DTH vs. DTOL) (1% vs. 2%; p¼0.301, 11% vs. 9% p¼0.543) of the matched cohort. At 30-day, 1-year and 2-year follow-up time points, mortality rates were significantly higher in the DTOL group than the DTH group ((95% vs. 85%), (89% vs. 71%) and (79% vs. 59%) respectively; stratified log rank test: p ¼ 0.0016). Conclusions: Findings from this propensity score matched study show that, at long term follow-up, TAVR patients discharged to another location other than home experience high mortality compared to their home counterparts. Meticulous patient follow-up care is warranted in DTOL patients after TAVR. Keywords: TAVR, Discharge location, Aortic stenosis
The American Journal of Cardiologyâ MARCH 23e26, 2017 13th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
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