Combination Therapy With Nicardipine and Isosorbide Dinitrate to Prevent Spasm in Transradial Percutaneous Coronary Intervention (from the NISTRA Multicenter Double-Blind Randomized Controlled Trial).

Verapamil and nitroglycerin are widely used to prevent radial artery spasm (RAS) during percutaneous cardiovascular procedures. However, these agents are not typically available in most African countries and consequently, isosorbide dinitrate is often the only spasmolytic treatment. Our aim was to compare the efficacy of isosorbide dinitrate alone versus isosorbide dinitrate used together with nicardipine to prevent RAS during transradial coronary procedures.

Design and Rationale of the National Tunisian Registry of Percutaneous Coronary Intervention: Protocol for a Prospective Multicenter Observational Study.

Background: Coronary artery diseases remain the leading cause of death in the world. The management of this condition has improved remarkably in the recent years owing to the development of new technical tools and multicentric registries.

Objective: The aim of this study is to investigate the in-hospital and 1-year clinical outcomes of patients treated with percutaneous coronary intervention (PCI) in Tunisia.

Prognostic impact of diabetes mellitus on patients managed by urgent percutaneous coronary intervention.

Introduction: Diabetes Mellitus (DM) is known to be associated with worse outcomes following percutaneous coronary intervention (PCI).

Aim: To assess prognostic impact of DM on patients managed by urgent PCI following ST-segment elevation myocardial infarction (STEMI).

Methods: In a retrospective study, STEMI patients admitted to our department from January 2016 to December 2019 and treated with urgent PCI (primary or rescue PCI) were included.

Inverted Takotsubo Following a Ruptured Ectopic Pregnancy, Treated with Levosimendan.

Background: Takotsubo syndrome is a transient stunned myocardium that typically involves the apical and mid-ventricular segments. A variant, called Inverted Takotsubo, concerns the basal and mid-ventricular segments.

Case Summary: We present a ruptured ectopic pregnancy that was responsible for a catecholamine surge, which led to this stress-induced cardiomyopathy.

Outcomes and prognostic factors of patients treated for in-stent restenosis: a retrospective single-center experience.

Background: The incidence of in-stent restenosis (ISR) remains relatively common despite the use of drug-eluting stents. Outcomes and prognostic factors following ISR revascularization are still being investigated. We aimed to describe the outcomes following different ISR treatment strategies in order to identify prognostic factors associated with worse outcomes.

Distal radial approach versus conventional radial approach: a comparative study of feasibility and safety.

The distal radial approach (DRA) is suggested to have benefits over the conventional radial approach (CRA) in terms of local complications and comfort of both patient and operator. Therefore, we aimed to compare the feasibility and safety of DRA and CRA in a real life population. We conducted a prospective, observational multicentric trial, including all patients undergoing coronary procedures in September 2019.

Epidemiology of thromboembolic and hemorrhagic events in patients with atrial fibrillation under anti-vitamin K.

Background: Atrial fibrillation is the most common heart rhythm disorder in the general population. It is associated with increased cardiovascular morbidity and mortality. Given this risk, anticoagulant therapy is vital.

[Study of unexpectedly detected repolarization in a group of black athletes].

Introduction: Sudden death that occurs during sporting activity affects patients with ignored heart disease. Black athlete's ECG has been little studied and the features of this ethnic group have been discussed. This study aims to study the epidemiological profile and the peculiarities of repolarization of black athletes.

Design and Rationale of the National Tunisian Registry of Atrial Fibrillation: Protocol for a Prospective, Multicenter Trial.

Background: Atrial fibrillation (AF) is an important health problem in Tunisia. A significant change in the epidemiological pattern of heart disease has been seen in the last 3 decades; however, no large prospective multicenter trial reflecting national data has been published so far. Robust data on the contemporary epidemiological profile and management of AF patients in Tunisia are limited.

Incidence and risk factors of peripheral venous catheter-related adverse events in cardiology department of a Tunisian university hospital: A prospective observational study.

Aim: The purpose of our study was to determine the incidence and risk factors of Peripheral Venous Catheter-Related Adverse Events (PVCAEs) in a cardiology department of a university hospital.

Patients And Methods: We carried out a prospective observational study from Mars 2017 to May 2017 in the cardiology department of the University Hospital of Farhat Hached in Sousse, Tunisia. During this period, we actively followed-up all inserted PVCs (every 12hours) from insertion up to 48hours after removal.

[Evaluation of the quality of long-term anticoagulation therapy with antivitamin-K in atrial fibrillation].

Aim: To assess the quality of long-term anticoagulation therapy with antivitamin-K in patients with atrial fibrillation by measuring the TTR and to determine the factors associated with a good TTR.

Patients And Methods: This is an observational study conducted over a period of three years (from January 2013 until December 2015) in the outpatient clinic of cardiology of Farhat Hached hospital of Sousse, Tunisia. Pre-established individual plugs were used for data collection.

Clinical features and prognosis of infective endocarditis in children: Insights from a Tunisian multicentre registry.

Background: Infective endocarditis (IE) is a rare condition in the paediatric setting. No data on the epidemiology and prognosis of IE in children are available from North African countries.

Aim: To investigate the epidemiological profile and prognosis of IE in children in Tunisia.

Relationship between the A(8002)G intronic polymorphism of pre-pro-endothelin-1 gene and the endothelin-1 concentration among Tunisian coronary patients.

Background: Acute coronary syndromes (ACS) are complex and polygenic diseases which are a real problem of public health. These syndromes require multidisciplinary studies to understand the pathogenesis mechanisms. Our study aims to evaluate the endothelin-1 (ET-1) serum concentration in Tunisian coronary compared to controls healthy, as well as the study of the impact of an intronic polymorphism A (8002) G of pre-pro-endothelin-1 Gene (inactive precursor of ET-1) on the change in serum endothelin-1 and in the susceptibility to Acute coronary syndrome (SCA).

Metabolic interactions between hyperhomocysteinemia and endothelin-1 among Tunisian patients with acute coronary diseases.

Background: Acute coronary syndromes (ACS) are complex and polygenic diseases which are a real problem of public health. These syndromes require multidisciplinary studies to understand the pathogenesis mechanisms and metabolic interactions between different risk factors.This study aimed to explore the variation of two coronary risk parameters not mentioned by Framingham cohorts, hyperhomocysteinemia and endothelin-1 (ET-1) in Tunisian coronary and the study of the variation of these parameters based on various cardiac risk factors and metabolic relationship between them.

Delay of Fibrinolysis in ST- Elevation Myocardial Infarction: Results of an Investigation Conducted in a Single Center in Sousse Tunisia.

Background: The aim of our study was to assess the delay of fibrinolysis in ST elevation myocardial infarction (STEMI) in our region and to identify characteristics associated with prolonged delay.

Patients And Methods: We analyzed clinical characteristics of a prospective cohort of unselected patients admitted for (STEMI). The study was conducted over three years 2007-2009 and 250 patients were included in a single center without capability of percutaneous coronary intervention.

[Metabolic interactions between the hyperhomocysteinemia and angiotensin-1 converting enzyme activity in Tunisian patients with coronary heart disease].

Hyperhomocysteinemia and hyperactivity of the angiotensin-1 converting enzyme (ACE1) are considered two unconventional coronary risk factors. The study of the variation of these two biochemical parameters in coronary patients and metabolic investigation of the relationship between these two markers has a fundamental interest. In this context, 110 patients and 80 control subjects are recruited for our study.

[Permanent cardiac pacing: about 234 patients].

Background: Permanent cardiac pacing remains the only effective treatment for chronic, symptomatic bradycardia. In recent years, the role of implantable pacing devices has expanded substantially.

Aim: To compare the situation of patients with critical brady arrhythmias before and after pacing focusing on indication for pacemaker implantation, frequency of re intervention and early and late complications.

[Study of the intronic polymorphism of the angiotensin 1 converting enzyme among coronary Tunisians].

Background: The acute coronary syndromes (ACS) are classified among the major causes of mortality in the industrialized countries. The increased angiotensin I converting enzyme (ACEI) activity related to a genetic polymorphism constitutes a hereditary predisposition to these syndromes.

Aim: Evaluate the ACEI activity in Tunisian patients with coronary heart disease, and investigate the association between this activity and an intronic deletion of 287 pb on the intron 16 of the ACEI gene.

[Cardiac involvement in polymyositis].

Cardiovascular involvement in polymyositis constitutes a major cause of death. However, the cardiac location is rarely symptomatic and does not usually represent the principle clinical feature at the time of the initial presentation. We present here an unusual case of polymyositis with severe and polymorph cardiac disturbances that predominant the muscular signs.

Systemic embolism and septic shock complicated left atrial myxoma: case report.

Myxoma is the most common primary tumor of the heart. The rarity of infected cardiac myxomas leads to numerous diagnostic and therapeutic difficulties. We present a case of infected left atrial myxoma caused by methicillin-sensible Staphylococcus aureus in a 48-year-old woman complicated by systemic embolism and septic shock.

[Oral anticoagulants and atrial fibrillation].

Introduction: Oral anticoagulants (OA) are effective in the prevention of cerebrovascular events among patients with atrial fibrillation (AF). However, several studies showed OA to be widely underused in these patients. The purpose of this study was to assess the use of OA and associated factors with non-use of this treatment.

[Hydatid cyst of the right atrium].

Cardiac hydatid cysts are rare; the right atrial location is even rarer and carries serious complications. We report three cases of cardiac hydatid cyst of the right atrium. The first patient died in the postoperative period due to right heart failure and massive tracheal bleeding.

[Impact of diabetes on mortality after myocardial infarction].

Unlabelled: Myocardial infarction is a common cause of mortality in people with diabetes. The aim of this study was to determine early and mid-term mortality in diabetic patients with myocardial infarction and to determine if hyperglycemia was predictor of mortality. We conducted a retrospective study of 100 diabetic patients compared with 100 non diabetic patients who were hospitalised in our institution between 1999 and 2003 for myocardial infarction.