Followed Journals
Journal you Follow: 0
 
Sign Up to follow journals, search in your chosen journals and, optionally, receive Email Alerts when new issues of your Followed Journals are published.
Already have an account? Sign In to see the journals you follow.
Similar Journals
Journal Cover
European Heart Journal Supplements
Journal Prestige (SJR): 0.223
Number of Followers: 7  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1520-765X - ISSN (Online) 1554-2815
Published by Oxford University Press Homepage  [415 journals]
  • Value of Copeptin Measurement as A Novel Biomarker for Prognosis in Acute
           Heart Failure

    • Free pre-print version: Loading...

      Authors: Hassanein M; Sadaka M, Mokhtar A, et al.
      Abstract: AbstractBackgroundCopeptin, C-terminal segment of pro-arginine vasopressin, is expected to be a strong novel biomarker for prognosis in acute heart failure (AHF).AimEvaluate the prognostic role of copeptin in AHF either de novo or on top of chronic heart failure and its correlation with adverse cardiac events.MethodsThe study included 45 patients with acute decompensated heart failure (ADHF) to assess the relationship of serum copeptin level on admission and 72 hours after admission with adverse cardiac events (death, re-hospitalization and arrhythmias) in patients hospitalized with ADHF between May 2019 and November 2019 with median follow up period 6 months.ResultsIn this study, 15 patients died, re-admission for heart failure occurred in 22 patients and arrhythmias were documented in 14 patients with atrial fibrillation (n = 9) and ventricular arrhythmias (n = 5). Mortality rate was higher among the elderly, smokers and patients with higher heart rate, lower left ventricular ejection fraction, more frequent arrhythmias, impaired kidney function and higher copeptin level. Furthermore, copeptin level at day 1 with cutoff value of > 2.54 pmol/l predicted mortality with sensitivity of 86.67% and specificity of 53.33% while at day 3 copeptin level with cutoff value > 2.74 pmol/l predicted mortality with sensitivity of 93.33% and specificity of 83.33%. Finally, change in copeptin level between day 1 and day 3 was associated with increased mortality. (p<0.001)ConclusionSerum copeptin is suggested to be a strong biomarker to predict adverse clinical outcomes in patients with acute decompensated heart failure.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.018
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Outcomes of Radial Versus Femoral Approach in Patients with St Segment
           Elevation Myocardial Infarction Undergoing Percutaneous Coronary
           Intervention

    • Free pre-print version: Loading...

      Authors: Torkey E; Sanhoury M, Sadaka M, et al.
      Abstract: AbstractAim of the workTo compare transradial and transfemoral approaches in 1ry and rescue PCI for STEMI.MethodsThis prospective observational study was done at Alexandria University Hospital and International Cardiac Center from January 2020 to August 2020 by recruiting every patient had met our inclusion criteria (the third universal definition of MI) admitted to the coronary care unit after doing primary or rescue PCI 200 patients were involved.Exclusion criteria were (Thrombophilia and thrombocytopenia, known hematological abnormalities, and patients with known sever peripheral vascular disease.Randomization made by a computer-generated program into two equal parallel groups that were randomly assigned to either Radial access approach or femoral access approach for primary or rescue PCI. Chest pain to time of first medical contact (FMC), and the procedural time were computed. Coronary angiography and PCI procedure were described including materials used and the intra-procedure complications. MACE (Major Adverse Cardiac Events) or other hemodynamic complications were documented. All the patients were contacted for follow up to 6 months after the procedure by interviewing with the patients via telephone or the responsible physician to determine the outcomes procedure.ResultsThe distribution of demographic variables and risk factors were similar among 200 patients in the radial and femoral groups. There had been significant differences between the groups concerning the primary end point MACE after 6 months in favor of radial group patients with p value (0.004), there was significant deference between the two studied groups concerning the total bleeding complication with higher risk in femoral group 11% compared to radial group 3% with P value (0.02).Despite the nearly equal mean time from pain to FMC (9.01 hours in radial group and 9.2 hours in femoral group), the total procedural time was significantly longer in radial group compared to femoral group with (p value 0.037). However the rate of non-culprit vessel revascularsation was significantly higher in radial group 17% compared to 6% in femoral group with p value of (0.015).In-hospital stay was significantly shorter in the radial group patients P value (0.02).ConclusionTransradial approach is safe, and effective with a high procedural success rate as the transfemoral approach but with lower risk for bleeding vascular complications and other access site complications as hematoma especially for patients where aggressive antiplatelet and anticoagulation therapy is needed, or patients who are expected to suffer from access site complications as those who need rescue PCI.Transradial approach has major additional advantages of decreasing the incidence of MACE compared to transfemoral approach.Transradial approach has another advantages of decreasing the in hospital stay.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.010
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Angiographic and Clinical Predictors of Mild Non-Culprit Coronary Lesion
           Progression in Acute ST-Elevation Myocardial Infarction Managed by Primary
           Percutaneous Coronary Intervention: A Prospective Cohort Study

    • Free pre-print version: Loading...

      Authors: El-Awady W; Masoud M, Elmenshawy M, et al.
      Abstract: AbstractAimsTo identify the angiographic and clinical predictors of mild non-culprit coronary lesion (NCCL) progression in acute ST-elevation myocardial Infarction (STEMI).Methods and ResultsThe present prospective cohort study evaluated 200 patients with acute STEMI underwent primary percutaneous coronary intervention (PPCI) (either PPCI or pharmaco-invasive PCI) divided into2groups based on whether the clinically driven non culprit lesion PCI existed or not into: Control group-1: 157 patients(78.5%) with non-progressed non culprit lesion (no additional PCI to the non-culprit lesion) and Study group-2: 43 patients(21.5%) with clinically driven non culprit lesion PCI (underwent additional PCI to progressed non-culprit lesions).Our study end point was the clinically driven non culprit lesion PCI (additional PCI to progressed non-culprit lesions). Asymptomatic patients were followed up by exercise ECG at 12 months and myocardial perfusion stress testing at 24 months.Multivariate regression analysis showed that the strongest independent predictor for progression of mild NCCL was complex morphology of culprit lesion (p < 0.001).Finally, a receiver operating characteristic (ROC) curve was performed to assess a cutoff value for predictors for NCCL progression after PPCI in Patients with STEMI.ConclusionsOur novel angiographic independent predictor was complex morphology of culprit lesion. And our novel clinical independent predictors were CRP cutoff more than 7.05mg/l, peak cardiac troponin I value cutoff more than 27.5 ng/ml, and age cutoff less than 57.5 years, could be used for early prediction of mild NCCL progression after PPCI for acute STEMI patients. This could be used for early diagnosis to avoid repeated PCI and proper management for better outcomes.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Heart Failure Challenge in T2DM

    • Free pre-print version: Loading...

      Authors: Elmaraghi O.
      Abstract: AbstractIntroductionHeart failure is a clinical syndrome caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress.1There are 463 million patient with diabetes mellitus all over the world .2 People with diabetes have a 2- to 5-fold higher risk of developing HF3, On the other hand more than 30% of patients with heart failure also have diabetes. Patients with heart failure and diabetes have a worse prognosis than those without diabetes4.UKPDs, Accord and advance trials showed that Intensive glycaemic control has not been shown to significantly impact the risk of HF.5,6SGLT2 inhibitor is a new class of drugs to treat diabetes by inhibiting SGT2 decreases glucose reabsorption and increases urinary glucose excretion, improving glucose control in the diabetic patient.7At 2015 EMPA-REG OUTCOME trial showed that Empagliflozin in addition to reduction of HBa1c, reduced the 3MAC by 14%, CV death by 38% and HHF by 35%.Is these cardiovascular benefit were a chance' 8Then DECLARE-TMI58, CNVAS and VIRTIS trials showed that Dapagliflizon, Canagliflozin and ertuglifozin respectively in addition to reduction of HBa1c, reduce HHFso it is a class effect. 9,10,11Because in these trials starting treatment at the preclinical stage may prevent HF progression and improve outcomes.ObjectiveWe have 3 questions to be answered:Are the benefits of SGLT2i similar in patients With and without HF' (Prevention and management of HF)Are the benefits of SGLT2i similar in patients with and without Diabetes'Are the benefits of SGLT2i similar in patients with HFrEF and HFpEF'There are 4 trials to answer these QuestionsDAPA HF, DELIVER, EMPEROR-Reduced and EMPEROR –Preserved.DAPA-HF and EMPEROR –Reduced include patients with HF with reduced ejection fraction, diabetic and non-diabetic the result of both was reduce the risk of worsening HF or death from cardiovascular causes regardless of the presence or absence of DM. 10,11ConclusionThe results of these trials FDA Approves Dapagliflozin for low EF-Heart Failure in diabetic and Non-diabetic. FDA had granted Fast Track status for empagliflozin. Waiting the result of other trials.12
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.008
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Role of Awareness Activities in Mega-Events

    • Free pre-print version: Loading...

      Authors: Ghanem N; ElShal A, Darwish S, et al.
      Abstract: AbstractBackgroundCardiovascular diseases remain to be one of the leading causes of death worldwide. There are some well-established risk factors such as a genetic disposition (hereditary), hypertension (high blood pressure), diabetes mellitus, obesity, high cholesterol level, poor dietary habits, inactive lifestyle, and smoking. The Egyptian direction is to invest in developing educational programs on cardiovascular diseases for the whole community and particularly for women. This initiative is echoed by experts who call for urgent action to improve care, prevent disease and increase awareness of cardiovascular diseases generally and within the women community. The Egyptian community is in great need to public awareness campaigns about cardiovascular diseases especially myocardial infarction and stroke. The CardioVascular Research, Education, Prevention foundation (CVREP) in collaboration with Stent Save a Life (SSL) initiative Egypt and the American Heart Association (AHA) and its initiative “Go Red For Women”, initiated a very successful awareness campaign for physicians and for public during the mega cardiovascular conference CardioAlex.21. ICOM Group (International Center for Organization and Marketing) in collaboration with Expand created a comprehensive public awareness program during CardioAlex.21 held in Alexandria, Egypt during the period 01 – 04 June, 2021.AimBuilding awareness to the community to the signs and the “must take actions” in cardiovascular emergencies, as heart attacks.MethodsA very creative campaign was held at the last day of CardioAlex.21 in Alexandria, Egypt, in which, ICOM and Expand teams organized a Marathon (Run) followed by an educational lecture for physicians and a session for public along with screening clinics stations for all attendees to have an onsite check up on their blood pressure and blood glucose level. “GO RED FOR WOMEN”, addressed the message for women to raise the awareness of cardiovascular risks and a very informative discussion was held. The audience questions were answered by SSL Board who moderated the session on a one-to-one story telling technique which made the sessions very interesting. Data was collected from persons who attended the session representing the Egyptian society.ResultsEighty persons attended the awareness day, 54% of which were middle-aged participants with an age mean of 50 years old. 60% were women, 55% completed secondary education or more and 77% of them reported to have heard about heart attacks while, more than half stated they knew someone who had it. This campaign raised the public awareness regarding cardiovascular disease and how a minute is life changing, knowing how to react if someone experienced one or more of the heart attack symptoms as well as the proper management of MI patients. Also, the healthy lifestyle after undergoing a PPCI procedure was discussed.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.019
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Comprehensive Study of Heart Rate Recovery and Altered Ventilatory
           Response to Exercise in Patients with Obstructive Sleep Apnea

    • Free pre-print version: Loading...

      Authors: Banawan L; Daabis R, Eshmawey H, et al.
      Abstract: AbstractBackgroundObstructive sleep apnea (OSA) is a chronic disorder that results in many cardiovascular disorders including hypertension, arrhythmias and congestive heart failure (CHF). Polysomnography is the gold standard for diagnosis of OSA, even though up to 93% of women and 82% of men with moderate to severe OSA still remain undiagnosed. Cardiopulmonary exercise testing (CPXT) has been conventionally used for evaluation of coronary artery diseases and rehabilitation of cardiac patients. Modern systems allow for the analysis of gas exchange at rest, during exercise, and during recovery and also yield measures of oxygen uptake (V O2), carbon dioxide output (V CO2), and minute ventilation (V E) together with heart rate, blood pressure, electrocardiography findings, and symptoms. This may have clinical utility if added to the available screening tools used to identify OSA.Aim of studyTo assess altered ventilatory response and heart rate recovery in response to exercise in patients with obstructive sleep apnea and their relation to its severity.Methods and ResultsCase control study was enrolled including 30 patients with obstructive sleep apnea (OSA) divided according to severity (5 mild, 8 moderate and 17 severe) and 15 control healthy overweight with sedentary lifestyle individuals. The two groups underwent cardiopulmonary exercise testing and different pulmonary and cardiac parameters were calculated. Greater VE, VE/VCO2, VE/VO2 ratios and VE/VCO2 slope were statistically significant regarding the patients group (P < 0.001, F = 69.053, 104.381, 140.806 and 68.010 respectively according to ANOVA test). OSA patients had a reduced maximal exercise capacity expressed as lower VO2 peak, decreased breathing reserve (BR) and VO2 at anaerobic threshold compared to control group (P < 0.001, F = 22.597, 68.773 and 82.90 respectively). Delayed heart rate recovery (HRR) and weaker chronotropic response (CR) in patients with OSA than in controls with negative relationship to severity of OSA were proved (p < 0.001, F = 119.493 and 91.271 respectively). The study revealed elevated maximal systolic BP (max SBP), diastolic BP (max DBP) and recovery SBP in the following 2 minutes after exercise in patients with OSA relative to their healthy controls with positive relationship to the severity of OSA (P < 0.001, F = 37.129, 169.275 and 244.609 respectively).ConclusionPatients with OSA demonstrated exaggerated ventilatory response to exercise and autonomic dysfunction reflected by measurement of heart rate variability and reduced maximal exercise capacity than healthy controls.AbbreviationsOSA, CHF, CPXT, VO2, VCO2, VE, VE/VCO2, VE/VO2, VE/VCO2, BR, CR, HRR, max SBP and max DBP.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.003
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Clinical Characteristics, Laboratory Profiles, And Treatment Modalities
           for Familial Hypercholesterolemia in Egypt

    • Free pre-print version: Loading...

      Authors: Reda A; Bendary A, Elserafy A, et al.
      Abstract: AbstractAimsThe aim of the Familial Hypercholesterolemia Research Collaboration (FHRC) is to collect date about the clinical, laboratory phenotypes, and treatment strategies of patients with FH all over the world. We present the Egyptian data of this international registry.Methods and ResultsAn online electronic case report form (e-CRF) was prepared to collect data matching the protocol of the FHSC of the European Atherosclerosis Soci- ety (EAS). From August 2017 to March 2021, a total of 228 cases with FH (46% males, mean age 48 ± 14 years) were enrolled. About 71% of whom came from urban areas. The mean Body Mass Index (BMI) was 30 ± 4.9 kg/m2. The most commonly reported concomitant risk factor was hypertension (39%), followed by smoking (22%), and then DM (18%). Median time from diagnosis to enrolment was 7 (range 0.5-20) years. The vast majority (99.1%) were diagnosed based on the Dutch Lipid Clinic criteria, with 14%, 11% and 75% in the definite, probable, and possible categories respectively. Genetic test was performed in only 1 patient, in which the defect was heterozygous FH (defective ApoB). Mean baseline levels for total cholesterol was 316±86 mg/dl, median (ranges) for triglycerides was 190 (38-1400) mg/dl, for LDL-C was 237±77 mg/dl and for HDL-C was 47±14 mg/dl. Importantly, the mean Lp(a) was 42±12 mg/dl. All but one patient received lipid lowering therapy. Statins were prescribed in 226 out of 228 patients enrolled (99.1%). Statin prescriptions were equally distributed between Atorvastatin and Rosuvastatin (41% for each). Forty five percent received monotherapy and 56% received combination therapy (most commonly with Ezetimibe [55.7%], then with Fibrates [7.9%], then with proprotein con- vertase subtilisin/kexin type 9 (PCSK-9 inhibitors) [2.6%], and finally with Omega-3 fatty acids [0.9%]). Only one patient received lipoprotein apheresis.ConclusionThe Egyptian part of the FHRC, to the best of our knowledge, is the first FH registry in Egypt. Our data show that the e-CRF system is feasible and reliable. The phenotype of enrolled FH cases showed higher female preponderance, very high lipoprotein levels, and unfortunately inadequate therapeutic interventions (with un- derutilization of PCSK-9 inhibitors). This is a call to action in order to mitigate these management gaps for this high-risk group.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.001
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Transcatheter Closure of Residual and Iatrogenic Ventricular Septal
           Defects: Tertiary Center Experience and Outcome

    • Free pre-print version: Loading...

      Authors: Taha F; Alnozha F, Amoudi O, et al.
      Abstract: AbstractAimThis study aimed to review our center experience in transcatheter closure of post-surgical and post-intervention residual and iatrogenic VSDs and to report on their 12-month long-term outcome.MethodsAll patients who underwent transcatheter closure of residual ventricular septal defects (R-VSDs) and iatrogenic ventricular septal defects (I-VSDs) after either surgical corrections or transcatheter interventions for any congenital heart disease (CHD) between January 2015 and January 2020 were included in the study. Patients' medical records were reviewed and analyzed.ResultsTwenty-three patients with a mean age of 14.3 ± 8.8 years, a mean weight of 36.2 ± 20.4 Kg, and a mean body surface area of 1.18 ± 0.36 m2 were included. Thirteen (56.5%) patients were males. The VSD was residual in 18 (78.3%) patients and iatrogenic in 5 (21.7%) patients, post-operative in 19 (82.6%) patients and post-transcatheter in 4 (17.4%) patients. The remaining VSD site was peri-membranous in 9 (39.1%) patients, high-muscular in 6 (26.1%) patients, mid-muscular in 4 (17.4%) patients, and Gerbode shunt in 4 (17.4%) patients. The QP/QS ratio was 2.5 ± 0.7, and the VSD diameter was 6.1±2.1 mm with a VSD-aorta rim of 5.4 ± 2.0 mm. Most, 16 (71.43%) patients underwent antegrade device deployment, and 7 (28.57%) patients underwent retrograde transaortic device deployment, with only 3 (13.0%) patients required two devices/patient. Amplatzer™ Muscular VSD devices were used in 16 (69.6%) patients, Amplatzer™ Duct occlude-I devices were used in 4 (17.4%) patients, and Amplatzer™ Duct Occluder-II devices were used in 3 (13.0%) patients with a mean device size of 8.8 ± 2.8 mm. The mean procedural time was 55.1 ± 16.2 minutes, fluoroscopy time was 16.3 ± 4.0 minutes, and the contrast used was 33.8 ± 10.9 ml. Concomitant balloon pulmonary valvuloplasty was done at the same catheterization set in 2 (8.7%) patients. Acute procedural success, satisfactory immediate were achieved in all patients. During follow-up (23.3 ± 15.9 months), no patient required re-intervention or exhibited mortality.ConclusionsTranscatheter closure of post-operative, and post-intervention residual and iatrogenic VSDs represents an attractive therapeutic approach. This approach is safe, feasible, effective, and less invasive alternative treatment option for such remaining VSDs.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.017
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Estimated Prevalence of Familial Hypercholesterolemia Among Egyptian
           Patients with Acute Coronary Syndromes; Analysis from The Cardiorisk
           Project

    • Free pre-print version: Loading...

      Authors: Reda A; , Bendary A, et al.
      Abstract: AbstractAimsThe prevalence of familial hypercholesterolemia (FH) in Egypt is largely un- known. We aimed to estimate the prevalence of FH among 3224 Egyptian patients with acute coronary syndromes enrolled from 2015 to 2018 in the nationwide cross- sectional cardioRisk project.Methods and ResultsWe applied the Dutch Lipid Clinic criteria for the diagnosis of FH on the available data recorded for the patients enrolled in the CardioRisk project. Two main criteria were applied: the presence of premature CAD (given 2 points in the Dutch criteria), and the categorized low density lipoprotein cholesterol (LDL-C) lev- els (given 1, 3, 5, or 8 points in the Dutch criteria according to the level). From a total of 3224 patients, 2743 patients had available LDL-C levels. Among those patients, when applying the abovementioned 2 criteria, we estimated that 472 patients had at least ‘possible’ FH (17.2% of the total population). Specifically, 4 patients had ‘defi- nite’ FH (0.1%), 7 patients had ‘probable’ FH (0.25%), and 461 patients had ‘possi- ble’ FH (16.8%).ConclusionThe estimated prevalence of at least ‘possible’ FH among Egyptian patients with ACS is 17%.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.006
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Thrombolysis Versus Redo-Surgery for Treatment of Mechanical Prosthetic
           Mitral Valve Thrombosis in Young Adult Patients

    • Free pre-print version: Loading...

      Authors: Kamal Y; Elshorbagy A, Mubarak Y, et al.
      Abstract: AbstractObjectivesTo evaluate and compare outcome of redo-surgery and thrombolysis for treatment of mitral PVT following mechanical valve replacement for rheumatic etiology in young adult patients (<50 years old).Methods and ResultsThis retrospective study included 42 young adult patients who had PVT after mechanical valve replacement for rheumatic mitral valve disease, between January 2014 and June 2019. Eighteen patients underwent redo-surgery and 24 patients underwent thrombolysis (Streptokinase 100,000 U/h for at least 24 hours). The approach of treatment was based on proposed criteria considering hemodynamic status, NYHA functional class, and thrombus size. Complete response to thrombolysis was defined by normal clinical and echocardiographic parameters. Primary outcome included response to thrombolysis, complications, mortality, and recurrence. The median follow-up period was 24 months. The thrombus size was significantly larger in redo-surgery group (9.88±2.44 mm2 vs 5.87±1.26 mm2, P < 0.001). The response to thrombolysis was complete recovery (70.8%), partial recovery (16.7%), or failure (12.5%). There was no significant difference in the incidence of major complications. Mortality was significantly higher in redo-surgery group (27.8% vs 4.2%, P = 0.03), with cumulative survival of 72.2% for redo-surgery versus 95.8% for thrombolysis (Log-rank P-value = 0.04). The reduced cumulative survival with redo-surgery was more evident in patients with delayed presentation (> 1 week). Recurrent thrombosis occurred only with thrombolysis (8.3% vs 0%, P = 0.20). Cumulative proportions for freedom from thrombosis were 100% for surgery versus 78.1% for thrombolysis (Log-rank P-value = 0.17).VariablesTotal (n = 42)Redo-surgery (n = 18)Thrombolysis (n = 24)P-valueFollow up (months)20.85±12.5321.72±13.0120.20±12.400.70Complications5 (11.9%)2 (11.1%)3 (12.5%)0.89Major complications2 (4.8%)1 (5.6%)1 (4.2%)0.92Mortality6 (14.3%)5 (27.8%)1 (4.2%)0.03*Early mortality4 (9.5%)3 (16.7%)1 (4.2%)0.17Late mortality2 (4.8%)2 (11.1%)0 (0%)0.09Recurrent thrombosis2 (4.8%)0 (0%)2 (8.3%)0.20NYHA class (follow up)1.52±0.701.61±0.691.45±0.720.49INR (follow up)2.91±0.452.94±0.552.89±0.370.73ConclusionsProper patient selection may improve outcome after treatment of mitral PVT using thrombolysis or redo-surgery in young adults. Redo-surgery has advantages over thrombolysis regarding mid-term recurrence of thrombosis; however, thrombolysis has significantly lower mortality than redo-surgery. Further evaluation of the proper treatment for delayed presentation of PVT is recommended.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.016
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Egyptian Association of Vascular Biology and Atherosclerosis Consensus on
           The Usage of SGLT2 Inhibitors in Heart Failure

    • Free pre-print version: Loading...

      Authors: Reda A; Elserafy A, Farag E, et al.
      Abstract: AbstractAimsAnalysis of SGLT2i data from DAPA-HF and EMPEROR- reduced trials to put a simplified consensus statement on the use of these glucose lowering agents in patients with established heart failure.Methods and ResultsSixty experts in the field of cardiology revised the literature of the SGLT2i in heart failure, their recommended indications, and their contraindications. Data from DAPA-HF and EMPEROR-reduced trials were tabulated and statistically analysed. SGLT2 inhibitors investigated initially for their glucose lowering capability, have shown a significant benefit in chronic heart failure eit reduced ejection fraction (HFrEF).ConclusionsWe recommend early use of dapagliflozin 10 mg, or empagliflozin 10 mg in patients suffering from symptomatic chronic HFrEF, whether the patient is diabetic or non, to improve heart failure hospitalization, death, symptoms, and decline of renal function.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.005
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Study of Pulmonary Hypertension and Its Predictors in Patients with
           Chronic Obstructive Pulmonary Disease

    • Free pre-print version: Loading...

      Authors: Hamada S; El Hoshy M, El Hoshy M, et al.
      Abstract: AbstractBackgroundPulmonary hypertension (PH) is one of the most common complications of chronic obstructive pulmonary disease (COPD). PH in COPD is caused by many factors mainly hypoxia.AimThe aim was to assess prevalence and predictors of PH in COPD patients.Patients and methodsA prospective, observational study was carried out on 100 patients diagnosed with COPD admitted at chest department of Alexandria university hospitals and Al. Mamoura chest hospital. All patients were subjected to complete medical history taking (Age, sex, smoking index, history of previous hospital admission for COPD exacerbation and history of previous ICU admission for the same reason), routine laboratory investigations including complete blood count (CBC), arterial blood gases (ABG), pulmonary function test (FEV1, FVC, FEV1/FVC ratio), Body mass index(BMI), six minute walk test, COPD assessment test (CAT) score, dyspnea assessment by modified Medical Research Council(m MRC) and Echocardiography relevant data (right atrial area, left atrial size, ejection fraction, valvular heart disease, PH, right ventricular function TAPSE (Tricuspid annular plane systolic excursion), systolic pulmonary artery pressure (SPAP) and tricuspid regurge velocity if present.ResultsA total of 100 COPD patients were included in the study 88 (88%) were males and 12 (12%) were females. Among patients with pulmonary hypertension 32 (94.1%) were males and 2 (5.9%) were females.On the other hand, 84.8%(n = 56) of patients without PH were males and 15.2%(n = 10) were females. Mean ± SD age of the patients was 60.12 ± 8.59 years. Mean ±SD age of the patients with pulmonary hypertension was 61.26±7.97 years, and for patients without PH mean± SD was 59.53 ± 8.88 years. With no statistically significant difference between the two groups.PH was diagnosed in 34 (34%) of patients, m PAP ≥25mmHg, of whom11 (32.4%) showed severe PH m PAP ≥40mmHg, 23 (67.6%) mild, moderate PH.ConclusionAlthough, the most important factors predicting PH in COPD patients were FEV1 and EF, respectively, but in COPD patients with severe PH was FEV1.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.015
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Comparative Study Among Three Different Models for Induction of Acute
           Myocardial Infarction in Rats

    • Free pre-print version: Loading...

      Authors: Elshaer A; Sobhy A, Elalfy M, et al.
      Abstract: AbstractAimLaboratory study of Acute Myocardial Infarction (AMI) has become of great importance for further investigations about prevention, diagnosis and treatment of the increasing number of patients worldwide. In this study, we are seeking the best experimental AMI model by comparing three methods by which AMI can be experimentally induced in rats to illuminate the most reliable model to use in further studies.Methods and ResultsExperimentally, AMI can be produced by either drug induced methods or surgical methods. Here, we compared two drug induced methods (isoproterenol and doxorubicin) and a surgical model to find out which method is best simulating human AMI.50 male sprague dowley rats were put into 5 groups, each contained 10 rats as follows. Surgical group in which the proximal left anterior descending coronary artery (LADCA) was dissected and ligated. Isoproterenol group in which Isoproterenol (300 gm/kg) was injected in ten rats subcutaneously on 2 doses a day apart. Doxorubicin group in which doxorubicin (2.5 mg/kg) was given intraperitonially every other day for total cumulative dose of 15 mg/kg. Control group where rats received only 2 ml of saline intraperitonially or subcutaneously. Sham group where rats underwent a similar surgery, but without LADAC ligation.After the induction, the biochemical parameter (serum Troponin I) at 12, 24, 36, 48 and 72 hours and histopathological changes (using hematoxylin, eosin and Mallory's trichrome stains) in all groups on days 1, 7, 14 and 21 were recorded. Data were statically analyzed, and Troponin curves were designed for each group to be correlated with that of AMI in human.After 7 days, histopathological studies of the surgical group exhibited wide areas of focal fibrosis at the apex and scattered mononuclear inflammatory cells infiltration. While the isoproterenol group showed moderate degree of inflammation with multifocal areas of fibrosis and scattered mononuclear inflammatory cells. However, the doxorubicin group showed more or less normal histology of cardiomyocytes.Biochemical studies reflected a significant difference in serum Troponin levels and peak timing among the groups. The surgical and isoproterenol groups Troponin peaked around 24 hours after the intervention, with higher levels in the surgical group. However, the doxorubicin group showed lower peaks around 36 hours post intervention.Correlations with human AMI histopathology and biochemical markers show more mimicking changes in the surgical group when compared to the other models, followed by the isoproterenol group and least similar in the doxorubicin- induced group.However, the survival rate of rats in the isoproterenol group was superior, followed by the surgical group and the doxorubicin group showed the lowest survival rates.ConclusionsSurgical induction of AMI in rats achieves the high similarity to AMI in human but the low survival rates jeopardize the reliability of the model. However, isoproterenol shows sufficient levels of mimicking and higher survival indicating the highest reliability in simulation. Doxorubicin based models are the least reliable.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.002
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Study of Global Longitudinal Strain and N Terminal Pro BNP as Predictors
           of Outcome in Acute ST-Segment Elevation Myocardial Infarction Patients
           Undergoing Primary Percutaneous Coronary Interventions

    • Free pre-print version: Loading...

      Authors: Magdy G; El-tahhan S, Ahmed F, et al.
      Abstract: AbstractBackgroundRisk stratification of patients presenting with Acute ST-segment elevation myocardial infarction (STEMI) is of greatest importance as it may help to start early therapeutic procedures that could improve the outcome. Our study is designed to assess the prognostic value of N-terminal pro brain natriuretic peptide (NT-proBNP) and global longitudinal strain (GLS) of the left ventricle measured by 2 dimensional speckle tracking echocardiography (STE) in patients presenting with acute STEMI and treated by primary percutaneous coronary interventions (PPCI).Patients and Methodsthe study prospectively included 100 patients(their age 55.69 ±8.70 years, and 75% were males)presented to our institute (from march 2019 to December 2019) by acute STEMI and treated by PPCI within 12 hour of the onset of chest pain, excluding those with left ventricular ejection fraction ≤40%, left bundle branch block, atrial fibrillation, significant valvular disease, patients with non cardiac causes that interfere with NT-Pro BNP level eg.(renal failure, chronic obstructive pulmonary disease, acute respiratory distress syndrome, pneumonia, liver cirrhosis, hyperthyroidism, and on those on chemotherapy). All patients were subjected to peripheral samples of plasma for analysis of NT- proBNP and 2dimentional STE for calculation of the GLS, both were done within 24 hours of admission, and follow up of all patients were done for 6 months to assess outcome.ResultsThe mean GLS for all patients was -10.41 ± 3.59%, and the mean NT- proBNP (2090.1 ± 1375.8) pg/ml. 20 patients (20%) had adverse events during the 6 month follow up including (1(1%) had all cause mortality, 2(2%) had cardiovascular mortality, 6(6%) had reinfarction, 11(11%) had heart failure hospitalization, and according to ROC curve analysis the GLS cut off value of (≤- 8) was able to discriminate patients with adverse outcome (AUC=0.971, p value<0.001,CI=“0.940-1.001”,sensitivity=90%, specificity=91.67%, PPV=78.3%, NPV=96.5%) (figure 1, 2), also according to ROC curve analysis NT-pro BNP cut off value of (>2318pg/ml) was able to discriminate patients with adverse outcome (AUC=0.802,p value<0.001, CI=“0.685-0.920”, sensitivity=89%, specificity=75%, PPV=51.6%, NPV=91.8%) (Figure 3, 4).Figure 1:ROC curve for (GLS) to predict STEMI patients with adverse outcomeFigure 2:example of GLS of one of the STEMI patients who was hospitalized for heart failure showing markedly reduced GLSFigure3:ROC curve for NT-pro BNP to predict STEMI patients who had adverse outcomeFigure 4:ROC curve for both (GLS) and N-proBNP to predict STEMI patients who had adverse outcomeThere was a statistically significant inverse correlation between GLS and NT- ProBNP (r=-0.492*, p value<0.001). In multivariate COX regression analysis for the parameters affecting the outcome, GLS was shown to be the most significant parameter in the prediction of reaching adverse outcome in STEMI patients (p value=0.003, OR “95%C.I”= 0.721 (0.580–0.896).Conclusionsour study concluded that both GLS and NT-proBNP are significantly related to adverse outcome with more superiority of the GLS to NT- pro BNP in adverse outcome prediction in patients acute STEMI treated by PPCI.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.014
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Evaluation of Left Ventricular Dysfunction in Patients with Isolated
           Mitral Valve Stenosis Using Speckle Tracking Echocardiography

    • Free pre-print version: Loading...

      Authors: ElGendi M; Ayman M, Sadaka M, et al.
      Abstract: AbstractAimThe aim was to evaluate left ventricular (LV) systolic function in patients with isolated mitral stenosis (MS) using 2D speckle tracking echocardiography.Methods24 patients (39.50 ± 5.55 years, 17 females) with isolated MS (MVA: 1.35 ± 0.16 cm2) with preserved LV systolic function and sinus rhythm were compared to 12 matched healthy control subjects (36.42 ± 5.99 years, 8 females). Conventional echocardiography was performed to both groups. Longitudinal strain and Circumferential strain echocardiography were obtained. Peak systolic strain was measured from the mean strain profile for a total of 17 segments of the LV for the longitudinal strain and 16 segments for the circumferential strain. Global longitudinal (G.L.) and circumferential strain (G.C.) were calculated separately as the average of the sum of the studied segments.ResultsThe global longitudinal strain of the cases group ranged from -11 – -17% with a mean value of -14.67 ± -1.69% and that of the control group ranged from -15 – -20% with a mean value of -17.83 ± -1.53% with a statistically significant difference between the two groups.In our study, there was a negative but non-significant correlation between LV GLSS and LA diameter (r = -0.054, p = 0.802), Echo score (r = -0.018, p = 0.933) and PASP (r = 0.021, p = 0.922) in patients group.Also, the correlation was negative but non-significant between LV GCSS and LA diameter (r = -0.142, p = 0.507), Echo score (r = -0.200, p = 0.349) and PASP (r = -0.155, p = 0.471) in patients group.Cases (n = 24)Control (n = 12)pG.L. strain (%)Min. – Max.−11.0 — −17.0−15.0 — −20.0<0.001*Mean ± SD.−14.67 ± −1.69−17.83 ± −1.53Median−15.0−18.0Conclusion• 2D speckle tracking echocardiography can detect subclinical LV systolic dysfunction which cannot be recognized by 2D conventional echocardiography.• Isolated rheumatic MS may be associated with subclinical LV systolic dysfunction.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.007
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Resuscitation After Cardiac Surgery Awareness an Egyptian Multicentre
           Survey

    • Free pre-print version: Loading...

      Authors: Abdelghafar M; Abdelmoneim T, Mohamed A, et al.
      Abstract: AbstractIntroductionThere has been an increasing recognition that cardiac surgery patients have different resuscitative needs than other medical and surgical patients who experience in-hospital cardiac arrest. This was addressed in the 2010 European Resuscitation Council Guidelines and the 2010 American Heart Association Guidelines. However, it’s unknown how widely the guidelines are practiced, or a training protocol is followed in different units in Egypt.ObjectivesThis national survey aims to identify the views and common practice of Egyptian cardiac teams regarding resuscitation after cardiac surgery.MethodsA 21-question survey is created based on a prior survey used by the EACTS guidelines committee. Questions included the following topics: Participants demographics, Prevalence of cardiac arrest in the intensive care unit, Cardiac arrest with ventricular fibrillation or non-shockable rhythm, Emergency resternotomy technique, Training and arrest protocols.Survey dissemination was through social media platforms, mobile messaging applications and emails during the time period between November 2020 and January 2021.ResultsOf 126 responses, 95 were suitable for inclusion. Responses were from 11 centres across Egypt. 68.5% of the respondents were surgeons while cardiac anaesthetists and intensivists formed 12.6% and 18.9% respectively. 76.8% of participants were middle-grade doctors, consultant participation was 23.2%.The median annual number of cases performed in the units was 480 and this ranged from 10 to 3000. The average percentage of cardiac arrests was 7%, Median survival to hospital discharge of all arrests was 33%For patients who go into VF after cardiac surgery, respondents would attempt a mean of 5 shocks with only 24.2% commencing defibrillation shocks before external cardiac massage, while the majority initiating CPR immediately. They would perform emergency resternotomy in a mean time of 12 mins and in 15 mins if the rhythm was not shockable. 56.8% would give 1 mg of adrenaline as soon the cardiac arrest was established, only 6.3% thought that it should be given rarely or not at all.If a surgeon was not immediately available 36.8% of respondents would be happy for any trained personnel to perform the emergency resternotomy while 58.9% expect only the surgeon to perform the resternotomy.49.4% of the participants have not practised any training to perform an emergency sternotomy. 41% of the respondents state they occasionally practice or talk with the staff about it. Only 9.5% practice regularly on emergency sternotomies. 25% assume current training is enough and does not need modification, while 75% think tailored training is important and staff should be oriented about it in the future.ConclusionAn action plan is required to improve the awareness of the junior surgeons with the Cardiac Advanced Life Support Protocol. Proper training of the intensive care staff to implement the protocol in a timely organised manner is needed. Assessment of the rhythm before starting external chest compressions is the corner stone in cardiac patients undergoing cardiac arrest. VF/pVT rhythm, 3 defibrillation shocks are given first; for the non- shockable rhythm, the emergency pacing switched on, this is followed by compressions till resternomtomy. Emergency resternotomy under 5 minutes is the only effective way to save patients with tamponade and extreme hypovolemia.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.013
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Modified Technique to Control the Eutachian Valve During Transcatheter
           Closure of Atrial Septal Defect/Patent Foramen Ovale

    • Free pre-print version: Loading...

      Authors: El Shedoudy S; Elsoud F, El Dokhlaha E, et al.
      Abstract: AbstractObjectiveto describe an approach to perform safe transcatheter closure of Atrial Septal Defect (ASD)/Patent Foramen Ovale (PFO) associated with large redundant Eustachian Valve.BackgroundTranscatheter device closure of ASD/PFO is feasible in a great majority of patients. However, the presence of a huge mobile Eustachian Valve can compromise device placement.Patients and MethodsSix patients (3 PFO and 3 ASD patients) with a huge redundant Eustachian valve were included. Two patients had PFO with long tunnel and were closed with Occlutech FigullaFlex II PFO occluders sized 23/25 and 27/30 respectively. The other PFO patient had an associated atrial septal aneurysm (ASA) and was closed with a 25 mm Amplatzer Multi-Fenestrated Septal Occluder “cribriform” device (St. Jude Medical – Abbott Vascular). The three ASDs were closed by regular ASD occluders (2 Flex II ASD Occluders sized 30 and 33 mm and 1 Amplatzer ASD Occluder sized 24 mm).Eustachian valve was successfully held with a steerable ablation catheter to deflect it against the lateral right atrial wall, keeping it away from the inter-atrial septum to prevent its entrapment or interference with the cable, the sheath or the device.ResultsAll ASDs/PFOs have been successfully closed with no complications with free inferior vena cava (IVC) flow, with no residual inter-atrial shunt and the eustachian valve is not interfering with the device.ConclusionsSafe percutaneous ASD/PFO closure can be achieved with proper control of a large redundant Eustachian valve.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.009
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Prognostic Value of Cardiac Troponin I In Infective Endocarditis

    • Free pre-print version: Loading...

      Authors: Thabet S; Meshaal M, Yazied Y, et al.
      Abstract: AbstractAimThe aim of this study is to assess the prognostic value of cardiac troponin I as a predictor of in-hospital morbidity and mortality in patients with infective endocarditis.MethodsThis study included 48 patients with definite and possible IE according to modified Duke’s criteria for diagnosis of IE. This prospective longitudinal study was conducted on patients admitted to the cardiovascular department of Cairo University hospitals. All patients were subjected to full history taking and clinical examination, all laboratory and radiological investigations which included chest radiography, echocardiogram and other diagnostic procedures as needed for diagnosis and follow-up of IE were done with emphasis on cardiac troponin I level on admission.ResultsTroponin I was found to be statistically significant predictor for heart failure (NYHA III/IV), septic pulmonary embolism and in-hospital mortality in infective endocarditis patients by univariate and multivariate regression analysis with P values 0.023, 0.037and 0.002 respectively. Tricuspid valve vegetations had showed significant relation to troponin I levels with p value 0.033. Also it was found that SOFA score on first day of admission showed significant relation to troponin I level with P value 0.045 and 0.004 for prediction of hospital stay duration. Shock and intracranial hemorrhage showed borderline significance with P values 0.097, 0.069. On other hand, troponin I as predictor of pulmonary edema, mechanical complications, systemic embolization, acute kidney injury and presence of aortic root abscess had no statistical significance in our studied patients.ConclusionsThis study showed that there is as significant predictive value of elevated cardiac troponin I with heart failure, septic pulmonary embolism and all cause in-hospital mortality. In addition, it was significant predictor of the length of hospital stay, lymphocytosis and SOFA score. These results are emphasizing that cTn I level may predict higher risk patients who would need early and aggressive control of infection medically alone or combined with surgery in IE patients.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.011
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Correlation Between Left Ventricular Electromechanical Delay and Body Mass
           Index

    • Free pre-print version: Loading...

      Authors: Salem A; Abazeed S, Elhawary A, et al.
      Abstract: AbstractAimTo evaluate effect of body mass index on left ventricle electromechanical delay among adults with no history of cardiac disease. Obesity is a complex disorder involving an excessive amount of body fat. Being extremely obese increases the risk of diseases and health problems, such as heart disease, type 2 diabetes mellitus, hypertension and premature death.The assessment of LV dyssynchrony has been gaining interest because it is increasingly considered to indicate the risk of progression to heart failure in various populations.Ventricular electromechanical delay can be measured from the onset of the QRS complex on electrocardiogram to the onset or peak of ventricular contraction determined by tissue Doppler imaging.Methods66 subjects divided into three groups with 22 subjects for each group with age range (≥18 years and < 60 years old) of either sex with no history of cardiac disease were classified according to BMI into three group; Group A: subjects with normal BMI (18.5 – 24.9 kg/m2 ), Group B: overweight subjects with BMI (25-29.9 kg/m2), Group C: obese subjects with BMI (≥ 30 kg/m2). The study groups were age, gender and risk factors matched. The time from the beginning of the QRS complex (on electrocardiogram) to the onset of systolic velocities in the septum and lateral wall were assessed and the time from the beginning of the QRS complex (on electrocardiogram) to the peak of systolic velocities in the septum and lateral wall were assessed using the pulsed wave Tissue Doppler Imaging (PW-TDI) by placing the sample volume in the middle of the basal portions of the LV septal and lateral walls in the apical four-chamber view at end-expiratory at a sweep speed of 100 mm/s, The difference between time recorded from septal and that recorded from lateral walls was referred as the lateral-to-septal delay.ResultsThere was significant difference between the three groups regarding (lateral to septal delay) from onset of QRS to onset of S'(23.36±7.6 ms vs. 24.05±5.9ms vs. 35.18±9.3ms respectively, P < 0.0001), also there was a significant difference between study groups regarding (lateral to septal delay) from onset of QRS to peak of S'(39.41±9 ms vs. 48±10.4ms vs. 62.82±15.3ms respectively, P < 0.0001). There was a direct correlation between BMI and (lateral to septal delay) onset of QRS to peak of S' (r = 0.633, P < 0.0001) as well as (lateral to septal delay) onset of QRS to onset of S'(r = 0.64, P < 0.0001).ConclusionWe present an interesting finding of left ventricular electromechanical delay in asymptomatic obese subjects with sinus rhythm and no history of cardiac disease. It would be speculative to say that the intraventricular dyssynchrony seen in asymptomatic obese individuals is related to cardiac electrical remodeling occurs with obesity and gives a proposal to understand pathophysiology of heart failure occurring in obese patients.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.004
      Issue No: Vol. 23, No. Supplement_D (2021)
       
  • Prospective Descriptive Study to Evaluate the Impact of Clinical
           Pharmacist in Antiplatelet Utilization and Safety in Coronary Heart
           Disease Patients

    • Free pre-print version: Loading...

      Authors: Nematalla H; Wafaie R, Elaziz E, et al.
      Abstract: AbstractAimTo evaluate the interventions associated with integration of a clinical pharmacist for antiplatelets best utilization and safety as multidisciplinary team approach is recommended to improve patient outcomes.Methodsprospective observational study on coronary heart diseases patients (stable angina, unstable angina, MI, post PCI or post CABG) on antiplatelets therapy (single antiplatelet; SAPT, or dual antiplatelet; DAPT) at governmental and private hospitals. Detailing pharmacist-initiated interventions targeting pharmacotherapy optimization (Dose, duplicate and interactions), also adverse effects detection, and hospital re-admission (re-event of coronary insufficiency). Collecting patients' data by interviews and hospital records using validated check list. Statistical software IBM SPSS software package version 20.0, The Kolmogorov-Smirnov was used to verify the normality of distribution of variables, Mann Whitney test was used to compare between two categories for not normally distributed quantitative variables. Kruskal Wallis test was used to compare different categories for abnormally distributed quantitative variables. Spearman coefficient was used to correlate between quantitative variables. Linear Regression was used to detect the most affecting factor for affecting DAPT score and Precise DAPT. Significance of the obtained results was judged at the 5% level, calculate sample size by G Power3.ResultsThere is a significant correlation between cardiac related readmission and Precise DAPT score (P = 0.013).A statistically significant correlation is found between smoking and DAPT score (p = 0.015) but not with precise DAPT (P = 0.152). Also a significant linear association exists between DAPT type and DAPT score, for Aspirin + Clopidogrel (P = 0.010) (95%CI=-1.000 (-1.754 – -0.246), Aspirin + Ticagrilor (P = 0.012) (95%CI= 1.001 (0.228 – 1.774). The highly significant influencing variable in both scores, is the dose value, for DAPT score (P = 0.038), Precise DAPT (P = 0.001). The distribution of Myocardial infarction as cardiac related readmission and smoking are higher in males than females without statistically significant difference (P = 0.08), (P = 0.39), the absence of adverse effects and bleeding events is statistically significant in DAPT score (P = 0.041, 95%CI=1.706 (0.071 – 3.341) & precise DAPT score (P = 0.002, 95% CI= -15.95 (-25.832 – -6.074).ConclusionsImpact of a clinical pharmacist within cardiology department generated substantial pharmacotherapy optimization which improve the medication adherence, safety and clinical outcomes. Our study suggests pre-calculating DAPT and precise DAPT for all patients before treatment and commitment on DAPT period administration may decrease re-admission rate of patients.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/eurheartj/suab069.012
      Issue No: Vol. 23, No. Supplement_D (2021)
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 3.236.232.99
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-